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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]

Recent years have witnessed growing acceptance of gender and sexuality diversity in Australia; yet, its inclusion in the school curriculum remains contentious. Despite evidence to the contrary, there is a commonly held belief that parents consider the inclusion of such topics inappropriate. In the light of this, this paper focuses on an analysis of three qualitative items from an Australian national survey of parents of children attending government-funded schools. Informed by the responses to these questions, we sought to better understand the concept of age-appropriateness present in the discourses deployed by a (minority) number of Australian parents who did not support gender and sexuality diversity-inclusivity in the curriculum. Thematic data analysis identified three key themes used by parents to warrant gender and sexuality diversity curriculum exclusion based on age inappropriateness: namely, inclusion is 'confusing'; children are too 'immature'; and children are too 'easily influenced'. [ABSTRACT FROM AUTHOR]

Purpose: Participating in home and community activities can be influenced by environmental factors and parent strategies. Children on the autism spectrum are reported to participate less in home and community activities than their neurotypical peers. Little is known about environmental factors that may influence their participation, and ways parents support their child's participation. Materials and methods: Parents of children on the autism spectrum aged 5–6 years (n = 72) and 10–11 years (n = 94) completed the Participation and Environment Measure for Children and Youth. This study reports on the perceived support, barriers, and resources in the home and the community environment. Parents reported strategies they used to support their child's participation in home and the community. Results: Home environmental factors were identified as more supportive by the parents of younger children. The sensory quality of activities and social demands were factors identified as making community participation harder for both groups. Parents used a range of different strategies in the home and the community to support their child's participation. Conclusions: Identifying environmental barriers and supports to participation can assist in developing interventions to support meaningful participation in activities for children on the autism spectrum. Implications for rehabilitation: Skills required for the activity and preferences of children on the autism spectrum are important considerations when supporting their participation in activities. When exploring a child's level of participation, it may be helpful to ask parents about what their child can do with or without their support. The sensory quality of the environment is a consideration when supporting the participation of children on the autism spectrum in community activities. As sensory processing is an individual experience, the impact of sensory elements of the environment may differ for individuals. [ABSTRACT FROM AUTHOR]

Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents' perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6–11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents' Beliefs About Children's Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents' perceptions regarding the ER skills of their children. Results indicated that parents' beliefs about the need for guiding and supporting their child's ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents' awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents' beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions. [ABSTRACT FROM AUTHOR]

Objective: Nearly 45% of Australian families intentionally or unintentionally co-sleep, including bedshare. Parents' intentionality to co-sleep can influence their perceptions of sleep quality, family functioning and overall satisfaction. Yet very little is known about fathers' perspectives and experiences of co-sleeping with their children. This mixed-method study aimed to explore paternal co-sleeping intention and its association with perceived sleep quality. Method: Fathers with children who co-slept completed an online survey about their sleep arrangements and intentionality from the Sleep Practices Questionnaire, and their sleep quality from the Sleep Quality Scale. Open-ended responses about intentionality were analysed thematically. Results: One hundred and forty-one fathers were included in the analysis. Quantitative analysis found that fathers' whose children were sleeping where definitely intended had significantly better perceived sleep quality than fathers whose children were sleeping in an unintended location. A thematic analysis provided insight into the reasons for this relationship. Conclusions: This study offers insight into fathers' experiences of co-sleeping including bedsharing, and responsive night-time infant care practices. Paternal night-time involvement in infant care can influence father-infant bonding, maternal and paternal mental health and overall family functioning. The results and their implications for professionals working with fathers during the perinatal period are discussed. Key Points: What is already known about this topic: Co-sleeping (bedsharing and roomsharing) occurs in Australian families, both intentionally and unintentionally. Intentionality to co-sleep can influence a mother's perceptions of sleep quality, satisfaction and family functioning. Little research has examined fathers' role in co-sleeping, including their intentionality. What this topic adds: Shows how fathers' intention to co-sleep is related to their perception of sleep quality. Provides insight into how fathers who intend to co-sleep see the benefits for the child and the family. Provides insight into fathers' experiences of co-sleeping with their children. [ABSTRACT FROM AUTHOR]

Echolalia has been described as the repetition of words, phrases, songs or other more elaborate dialogues uttered by another person, which may be immediate or delayed (International Classification of Diseases, 11th Revision; Diagnostic and Statistical Manual of Mental Disorders, 5th ed.). Some classify echolalia as a communication impairment reflective of delay, while others consider it a restricted, repetitive pattern of behaviours, without meaningful communicative function. Little attention is given to the experiences of non-clinicians, such as parents or teachers who may hold valuable insights to further our understanding of this phenomenon. This study forms part of a larger programme of inquiry which interviewed parents (N = 133) about their experiences of their sons' and daughters' echolalia. Using hermeneutic phenomenological analysis in an abductive framework, we present a perspective of echolalia that has largely remained silent in literature: echolalia as an expression of neurodiversity. Participants push back against the status quo of intervention, reclaiming echolalia as being a part of their child's identity. Participants want their children to not only enjoy their echolalia but to fully embrace it as being a part of their individual identity. We propose alternatives to a purely clinical perspective of echolalia; alternatives that may place the neurodiversity-affirmative perspectives of our participants in a co-existing tension with clinicians. Echolalia is a commonly found speech and language condition in autistic children. Children with echolalia repeat words and phrases they previously hear in place of proving a non-repetitive response. In research and when visiting speech and language services, one of the common goals is to modify these repetitions so that these children may, more socially, engage with their surrounding environment. In our research, we identified that not all parents want their children's echolalia to be modified. Some parents want their child to be able to enjoy echolalia and others don't want anyone to intervene because they see it as something that makes their child unique and being unique is something to be celebrated. We believe that there might be a way for speech and language services who want to modify echolalia and the parents in our study who do not want their child's echolalia to be modified, to be able to exist side-by-side. [ABSTRACT FROM AUTHOR]

Online youth-focused health programs often include parent modules—that equip parents with skills to assist their child in improving their health—alongside youth-specific content. BRAVE Self-Help, an evidence-based program designed for children and teenagers with early signs of anxiety, is a popular Australian program that includes six parent modules. Despite its popularity and proven efficacy, BRAVE Self-Help shares the same challenge as many online self-help programs—that of low participant engagement. Using parents registered in BRAVE Self-Help as 'information rich' participants, we explored (a) factors that influenced parent engagement in online health programs, and (b) their recommendations for enhancing parent engagement. We conducted semi-structured interviews with 14 parents registered in BRAVE Self-Help. Data were analysed through reflexive thematic analysis. Social-, family- and program-related factors drove parents' program engagement and recommendations. Social sub-themes related to the benefits of professional and community support in promoting more engagement. Family sub-themes included difficulties with program engagement due to competing priorities, perceptions that condition severity influenced engagement, and feelings that previously-acquired health knowledge reduced motivation to engage. Program sub-themes included perceived usefulness and ease-of-use. Program designers could target support systems, include flexible delivery options, and use iterative design processes to enhance parent engagement. [ABSTRACT FROM AUTHOR]

The spread of COVID-19 resulted in restrictive lockdowns. For families supporting young people with autism spectrum disorder (ASD), the service system was stripped away. The aim of this study was to explore the impact of this challenging situation on a group of Australian carers and parents of children and young people with ASD, with an intention to inform policy and practice based on the lived experiences of these families. A survey of parents of children and young people with ASD in Australia returned 117 responses, of which 86 responded to open-ended questions about COVID-19 lockdowns. Twelve parents responded to the invitation to be interviewed. Interview and survey data were analysed thematically. Five themes emerged: accessing support services, receiving support services online, changes in behaviour, higher levels of conflict, and impact on health and relationships. The experience of lockdowns under COVID-19 undermined informal and formal support systems, and had a particularly strong negative impact on the experiences of children with ASD and their families. These findings also provide support for understanding the social model of disability as a mainstay in the lives of children with disabilities and their carers. IMPLICATIONS The social model of disability was dismantled for children and young people and their carers during the COVID crisis. This unacceptable attack on the human rights of disabled people (people with a disability) needs future planning to ensure that it does not occur again. Future crises require more nuanced policy and practice responses that do not close off all child and family supports to children with ASD and their carers. [ABSTRACT FROM AUTHOR]

Despite significant evidence worldwide that parents support school-based delivery of relationships and sexuality education (RSE), Australian data has generally lacked larger, nationally representative samples. Furthermore, misguided perceptions of parental attitudes are known to impact delivery. In response, online survey data were collected from 2,427 parents (56.5% female) nationwide, to examine their attitudes towards school-based RSE. Most had a child enrolled in a government school (65.3% primary, 55.7% secondary); and reported diverse religious affiliations (38.7% no religion, 21.3% Catholic, 11.1% Anglican) and voting preferences (26.7% Australian Labour Party, 25.1% Liberal/National, 23.6% undecided). Overall, 89.9% of parents supported schools to deliver RSE, with some modest differences being associated with particular demographic variables. Beyond widespread support for RSE, parents emphatically endorsed schools to address a diverse range of RSE-related issues (n = 40 topics). Parents' responses also provided insight regarding when certain topics should first be introduced and the quality of current RSE provision in schools. Findings from this descriptive overview challenge the currently overstated assumption that parents do not support RSE in schools. Such persistent and obstructive discourse is counterproductive to evidence-based strategies that seek to strengthen young people's personal and social development in a comprehensive and contemporary manner. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. Methods: This study utilized data from the Longitudinal Study of Australian Children (Waves 1–7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. Results: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Conclusion: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population. [ABSTRACT FROM AUTHOR]

Purpose: Busyness as a construct within modern healthcare is complex and multidimensional. To date, few studies have sought to explore how busyness influences family‐centred care. This study explored the influence of busyness on the delivery of family‐centred care for nurses and parents. Design and Method: Ethnography was selected as the research design. The study site was a metropolitan tertiary hospital inpatient paediatric unit in Sydney, Australia. Semi‐structured interview and non‐participant observation techniques were used for data collection. Ten paediatric nurses and 10 parents were interviewed and 40 h of non‐participant observations were undertaken. The COREQ was used to report the study. Results: The findings are presented as three key themes: (i) 'Supporting family‐centred care' in which participants detail beliefs about the nurse‐parent relationships and how despite busyness nurses sought out moments to engage with parents; (ii) 'Being present at the bedside' identified the challenges in optimising safety and how parents adapted their way of being and interacting on the unit; and (iii) 'The emotional cost of busyness' and how this influenced nurse‐parent interactions, care delivery and family‐centred care. Conclusions: The ethnography has given shape to social understandings of busyness, the complexities of paediatric nursing and family‐centred care. The culture of care changed in moments of busyness and transformed parent and nursing roles, expectations and collaborative care that at time generated internal emotional conflict and tension. Practice implications: Given the increasing work demands across health systems, new agile ways of working need to ensure maintenance of a family‐centred approach. Strategies need to be developed during periods of busyness to better support collaborative connections and the well‐being of paediatric nurses and parents. At an organisational level, fostering a positive workplace culture that shares a vision for family‐centred care and collaboration is essential. Patient or Public Contribution: Parents of sick children admitted to an acute paediatric inpatient ward were invited to be a participant in a single interview. Parents were aware of the study through ward advertisement and informal discussions with the researchers or senior clinical staff. Engagement with parents was important as healthcare delivery in paediatrics is focused on the delivery of family‐centred care. To minimise the risk of child distress and separation anxiety, children were present during the parent interview. Whist children and young people voices were not silenced during the interview process, for this study the parent's voice remained the focus. While important, due to limited resources, parents were not involved in the design analysis or interpretation of the data or in the preparation of this manuscript. Data sharing: The data that support the findings of this study are available from the corresponding author upon reasonable request. [ABSTRACT FROM AUTHOR]

Aims: To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self‐management and transition readiness. Design: Cross‐sectional international study, reported following STROBE guidelines. Methods: Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State–Trait Anxiety Inventory short form). Perceptions of health self‐management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. Results: Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self‐management and transition readiness. Conclusion: Transition readiness should be determined by an assessment of knowledge, self‐management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. Implications for Patient Care: Transition readiness and self‐management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. Reporting Method: We have adhered to the STROBE statement, using STROBE checklist for cross‐sectional studies. Patient or Public Involvement Statement: No patient or public involvement. Trial and Protocol Registration: ClinicalTrials.org NCT04631965. [ABSTRACT FROM AUTHOR]

Many trans young people seek mental health support and gender-affirming medical interventions including puberty suppression, gender-affirming hormones and/or surgeries. Trans young people and their parents face multiple barriers in accessing gender-affirming care and mental health support, however little is known about the parent perspective on accessing services for their trans child. This study aimed to understand the experiences of parents accessing medical and mental health services with and for their trans children within Australia. Using data from Trans Pathways, a large mixed-methods cross-sectional study, we examined the experiences of parents (N = 194) in Australia accessing primary care, psychiatry, therapy/counseling, mental health inpatient, and gender-affirming medical services with/for their trans children (aged 25 years or younger). Qualitative data on service experiences were thematically analyzed. Quantitative analyses included frequency of access to services, wait times, service satisfaction, and mental health diagnoses of the parents' trans child. Services were mostly first accessed when the young person was between 12 and 17 years of age, with primary care physicians being the most accessed service. Parents reported that some practitioners were respectful and knowledgeable about gender-affirming care, and others lacked experience in trans health. Across all services, common barriers included long wait times, complicated pathways to navigate to access support, as well as systemic barriers such as sparsity of gender speciality services. Across services, parents reported feeling as though they do not have the necessary tools to best support their child in their gender affirmation. This study highlights the crucial need for systemic changes in the processes of accessing gender-affirming care and mental health support to enable access to appropriate and timely care. These findings also indicate the importance of improving individual practitioner knowledge around trans health, to enhance the support provided to trans young people and their parents. [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]

Purpose: Schools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary school parents regarding school food and nutrition, including education, practices and policy. Design/methodology/approach: An online survey was conducted among 787 parents in March 2021, which included closed and open-ended questions. Findings: The results indicated the inconsistent implementation of policies and/or varying practices among different schools. Parents' views were slightly associated with some demographic and personal measures including their SES levels, education, age, the main language spoken at home and universalism values. Parents viewed healthy food provision through canteens, policies and informing parents, fruit and vegetable breaks and kitchen and garden programs as the main contributors to the promotion of healthy eating. They believed unhealthy options in canteens, school fairs, events and birthdays are the major contributors to the formation of unhealthy eating habits among children at schools. Results revealed the efforts to establish health promoting school food environments in Australian primary schools; however, inconsistencies and discrepancies among schools should be addressed to ensure equity among all children. Practical implications: The findings may provide directions for policymakers and school managers and can inform future reforms and initiatives in Australian primary schools and elsewhere. Originality/value: This is the first study that has examined Australian parents' views of school food policy, practices and environments using a mixed-methods design. [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 and aims: Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences – and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home–school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home–school partnerships study over time and (2) understand their experiences of being community partners on the home–school partnerships project. Methods: Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home–school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home–school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results: We found that parents' input fundamentally shaped the broader home–school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home–school partnership study – although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home–school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions: These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications: This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities. [ABSTRACT FROM AUTHOR]

Aims: To map the pathway and service provision for pregnant women whose newborns require admission into the surgical neonatal intensive care unit at or soon after birth, and to examine the nature of continuity of care (COC) provided and the facilitators and barriers to woman‐ and family‐centred care from the perspective of women/parents and health professionals. Background: Limited research exists on current service and care pathways for families whose babies are diagnosed with congenital abnormality requiring surgery. Design: A mixed method sequential design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. Methods: Data collection methods included: (1) a workshop with health professionals (n = 15), (2) retrospective maternal record review (n = 20), prospective maternal record review (17), (3) interviews with pregnant women given a prenatal diagnosis of congenital anomaly (n = 17) and (4) interviews with key health professionals (n = 7). Results/Findings: Participants perceived care delivered by state‐based services as problematic prior to admission into the high‐risk midwifery COC model. Once admitted to the high‐risk maternity team women described care 'like a breath of fresh air' with a 'contrast in support', where they felt supported in their decisions. Conclusion: This study highlights provision of COC, in particular relational continuity between health providers and women as essential to achieve optimal outcomes. Relevance to Clinical Practice: Provision of individualised COC offers an opportunity for perinatal services to reduce the negative consequences of pregnancy‐related stress associated with diagnosis of foetal anomaly. Patient or Public Contribution: No patient or public was involved in the design, analysis, preparation or writing of this review. [ABSTRACT FROM AUTHOR]

Purpose: Corporal punishment (CP) and physical abuse (PA) in childhood are associated with increased risk of child-to-parent violence (CPV). Without context of discipline (i.e., the intention of behavior change, and use of reasonable force), both CP and PA represent the use of physical force against a child. It is still unclear if their associations with CPV are similar when they co-occur, or when they occur in isolation. The current study examined the differential and cumulative association of different types of physical force in childhood with rates of CPV. Method: The sample consisted of 1,132 participants, between 18 to 87-years-old (M = 50.95, SD = 14.24) and included 59.5% female and 39.2% male participants who completed an online survey measuring CP, PA and CPV. Participants formed three groups: low CP or PA (group low), high CP only (group HCP), or high PA and CP (group PA + CP). Results: Two one-way ANOVAs with planned contrasts were conducted separately for CPV against mothers and fathers. The group HCP reported significantly higher CPV against both the mother and the father than group low and there was no significant difference between group HCP and group PA + CP. Conclusions: Higher rates of CP are associated with higher rates of CPV; however, this rate does not increase further when there is concurrent PA. This suggests that there may be a low sensitivity for retaliation from a young person, or coercive training (through high parent–child conflict), in environments where there is physical force from a parent. [ABSTRACT FROM AUTHOR]

Globally, we have seen a drop in adult and child quality of life (QOL) during the COVID-19 pandemic. However, little is known about adult or child QOL during the height of the pandemic in Australia and the impact of government-imposed restrictions, specifically attending school on-site versus home schooling. Our study aimed to establish if QOL in children and parents presenting to a Respiratory Infection Clinic in Victoria, Australia, for COVID-19 PCR testing differed from pre-pandemic population norms. We also explored whether on-site versus home schooling further impacted QOL. Following the child's test and prior to receiving results, consenting parents of children aged 6 to 17 years old completed the Child Health Utility 9 Dimension (CHU9D) instrument on their child's behalf. Parents of children aged birth to five years completed the EuroQOL 5-Dimension 5-Level (EQ-5D-5L) instrument on their own behalf (cross-sectional study). Data analyses utilised quantile regression, adjusting for the child's age, COVID-19 symptoms, gender and chronic health conditions. From July 2020 to November 2021, 2025 parents completed the CHU9D; the mean age for children was 8.41 years (±3.63 SD), and 48.4 per cent were female (n = 980/2025). In the same time period, 5751 parents completed the EQ-5D-5L; the mean age for children was 2.78 years (±1.74 SD), and 52.2 per cent were female (n = 3002/5751). Results showed that QOL scores were lower than pre-pandemic norms for 68 per cent of the CHU9D group and 60 per cent of the EQ-5D-5L group. Comparing periods of on-site to home schooling, there was no difference between the median QOL scores for both CHU9D (0.017, 95% CI −0.05 to 0.01) and EQ-5D-5L (0.000, 95% CI −0.002 to 0.002). Our large-scale study found that while QOL was reduced for children and parents at the point of COVID-19 testing during the pandemic, differing levels of government-imposed restrictions did not further impact QOL. These unique insights will inform decision-making in relation to COVID-19 and future pandemics. [ABSTRACT FROM AUTHOR]

The International Society for Pediatric and Adolescent Diabetes has identified school as a critical context for adolescents with type 1 diabetes (T1D) who typically hold a fluctuating, though growing, amount of responsibility for diabetes self-management across this time. When parents use frequent autonomy-supportive communication to maintain a mutually agreeable sharing of responsibility for diabetes management with their adolescent, better outcomes are achieved. There is, however, a dearth of research examining the way adolescent responsibility is managed at school. This cross-sectional study investigated adolescents' perspectives of sharing responsibility for T1D management at school and the extent to which these were concordant with parent perceptions. Sixty adolescents (10–19 years) and fifty-five parents completed questionnaires measuring the perceived impact of diabetes on adolescents' school activities and respective involvement in the management of responsibility for school-based diabetes care. Adolescent questionnaires also measured perceptions of autonomy supportiveness (Health Care Climate Questionnaire) and communication quality (frequency, mode, autonomy), in relation to diabetes management. Differences by age and inter-rater agreement between parent and adolescent dyads were examined. Results showed that parents and adolescents did not agree about their relative involvement in setting up diabetes management strategies or the impact of diabetes on school activities. There was no difference in the involvement of older adolescents relative to younger students. Adolescents predominantly communicated about school diabetes care in person, though some reported no communication with school staff (25%) or healthcare workers (36%). Only thirty nine (65%) reported having a diabetes school plan. Nineteen (32%) perceived little or no involvement in setting up diabetes care strategies for the year and most had not attended a school-related meeting. These results suggest more explicit inclusion of adolescents in formal school support strategies may better represent their unique perceptions of responsibility, enabling the consensual sharing of responsibility that is associated with better outcomes. [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]

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]

Parents and carers often have limited knowledge and confidence in providing comprehensive sexuality education (CSE) and support to children and young people with intellectual disability (ID) and/or autism spectrum disorder (ASD). To address this need, six workshops were delivered and evaluated in New South Wales (NSW), Australia in 2018. Pre/post-workshop surveys were completed (n = 145) along with three-month follow-up surveys and interviews (n = 34) to evaluate the perceived effectiveness of the workshops in improving parents' and carers' knowledge and confidence in providing CSE and support to their child or young person. The evaluation also sought to understand additional barriers for parents and carers in providing CSE and support to people with ID and/or ASD. Significant improvements in self-reported knowledge and confidence were identified following the completion of the workshop, which were retained at the three-month follow-up. Barriers to the provision of CSE and support included feelings of isolation and stigma, a preference for reactive approaches to CSE, and a lack of accessible information and resources. Findings suggest that while the provision of workshops to parents and carers can increase their knowledge and confidence in providing CSE and support, significant barriers persist. This evaluation provides insight into how the parent and carer approach to CSE and support for children and young people with ID and/or ASD can be improved. [ABSTRACT FROM AUTHOR]

Parents of children with hearing loss (HL) often navigate an unfamiliar and uncertain path. This qualitative study investigated the nature of parental uncertainty: (1) immediately after a child's HL was identified; (2) prior to primary school entry; and (3) during primary school. Open-ended questions in online surveys were completed by participants (N = 61) with: (a) personal experience as a parent of a child with HL (n = 35); (b) professional experience with children who have HL (n = 19); or (c) a combination of both parental and professional experience (n = 7). Six major themes were abstracted using thematic analysis, including uncertainty about: (1) the Pervasive Impact of HL, (2) the Nature and Causes of HL, (3) Developmental Impacts, (4) Family Life, (5) Family Decision-Making, and (6) Education and Support Services. The salience of these depended on the stage in time following identification. [ABSTRACT FROM AUTHOR]

Rapid genomic testing (rGT) enables genomic information to be available in a matter of hours, allowing it to be used in time-critical settings, such as intensive care units. Although rGT has been shown to improve diagnostic rates in a cost-effective manner, it raises ethical questions around a range of different areas, including obtaining consent and clinical decision-making. While some research has examined the perspectives of parents and genetics health professionals, the attitudes of intensive care clinicians remain under-explored. To address this gap, we administered an online survey to English-speaking neonatal/paediatric intensivists in Europe, Australasia and North America. We posed two ethical scenarios: one relating to obtaining consent from the parents and the second assessing decision-making regarding the provision of life-sustaining treatments. Descriptive statistics were used to analyse the data. We received 40 responses from 12 countries. About 50–75% of intensivists felt that explicit parental consent was necessary for rGT. About 68–95% felt that a diagnosis from rGT should affect the provision of life-sustaining care. Results were mediated by intensivists' level of experience. Our findings show divergent attitudes toward ethical issues generated by rGT among intensivists and suggest the need for guidance regarding ethical decision-making for rGT. [ABSTRACT FROM AUTHOR]

Physiotherapy is an essential component in the management of cystic fibrosis (CF). To explore how parents of infants with CF experience physiotherapy clinic consultations. A qualitative study, informed by hermeneutic phenomenology, utilizing in-depth semi-structured interviews and daily diaries was conducted with 13 parents of infants (aged 0–2 yrs.) receiving physiotherapy care for CF in Australia. Three themes arose from the text. The first was that parents' physiotherapy clinic experience is influenced by the manner in which health professionals communicate to parents about physiotherapy in CF, as well as their own prior experience and knowledge. Secondly, parents receive conflicting messages from the physiotherapy consultation, but perceive the key message to be to prioritize adherence to physiotherapy. The final theme was that parents' expectations of the physiotherapy interaction were often not met, in particular a lack of practical physiotherapy education and training was reported. Parents of infants with CF seek an optimistic, practical and hands on approach during physiotherapy consultations. Exploring options for providing physiotherapy input outside of traditional clinic environments may help accommodate individual needs. Investigation into the manner in which physiotherapy education is communicated to parents is warranted in light of the influence on parents' expectations of physiotherapy. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines for paediatric neuromuscular disorders (NMDs) recommend timely provision of wheelchair equipment. The aim of this qualitative study was to understand healthcare professionals' clinical perspectives and practices when recommending wheelchair equipment for the first time, as well as perceived barriers and enablers to timely wheelchair provision. Twenty-one healthcare professionals (HCPs) from Australia and the United States participated in an interview (response rate: 88%, 16/21 women). Participants were from diverse disciplines, based in hospital or community health settings, and had at least one year of experience working in paediatric neuromuscular care. Child fatigue, falls and engagement in age-appropriate activity were common reasons for HCP's wheelchair recommendation. HCPs were acutely aware of parents' experiences of grief and loss throughout the wheelchair prescription process, and over half acknowledged the lack of psychological care available to families affected by NMDs. Multi-disciplinary collaboration, psychologically-informed care, and shared decision-making with stakeholders were perceived enablers of wheelchair transition. Barriers included limited access to equipment, lengthy funding processes and lack of funding for home and vehicle modifications. Integrated psychosocial care is needed to support families throughout their child's disease progression, including wheelchair transition. Implementation of readiness for change tools, and development of tailored informational resources is recommended. Improved access to equipment options and trials, and more efficient funding processes are highly likely to improve parental engagement throughout the wheelchair prescription process. Healthcare professionals express a strong demand for integrated psychosocial care within paediatric neuromuscular clinics to support families throughout transitions, including wheelchair introduction. Identifying parents' readiness for change can inform their information and support needs, strengthen their decision-making capacity and facilitate timely wheelchair introduction. Stronger collaboration between hospital- and community-based health professionals working in paediatric neuromuscular care is recommended to facilitate knowledge exchange and support families' transition to wheelchair use. Access to equipment options for extended loan or trial in the community can support timely wheelchair introduction. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of life-limiting conditions in children and young people warrants an evaluation of paediatric palliative care, hospice services and delivered care. Aim: First, this study aimed to develop a deeper understanding of how extended viewing is experienced by the parents of a deceased child (or young person) with a life-limiting condition, based in Australia. Second, this study aimed to evaluate the quality of bereavement care delivered during the first few days after death. Findings: A total of 17 bereaved parents of 13 children completed an interview. In-depth interviews were audio-recorded, transcribed verbatim and thematically analysed. While the authors acknowledge the complexity and individual nature of grief, four broad themes were identified, namely the importance of the 'physical environment' being conducive to spending time with their child; 'seeing their child'; 'time to say goodbye'; and 'supportive care'. Conclusion: The findings of this study reinforce that extended viewing can provide therapeutic benefits for parents, as well as the importance of a skilled palliative care nursing workforce in assisting with grief management. [ABSTRACT FROM AUTHOR]

Paediatric acquired brain injury (ABI) negatively impacts parental wellbeing and family functioning. Adaptive coping, that is behaviours promoting emotional wellbeing and addressing distressing problems, may support wellbeing and family functioning. This study compared wellbeing, coping, and family functioning between parents of a child with ABI and parents in the community, and examined coping as a predictor of wellbeing and family functioning. Forty parents of a child with ABI and 40 parents in the community participated in this cross-sectional survey using the Personal Wellbeing Index, Coping Scale for Adults Short Form, McMaster Family Assessment Device (General Functioning Subscale). The ABI group had statistically significantly lower wellbeing, t(68.70) = −4.01, p < 0.001, lower adaptive coping, t(73.95) = −3.27, p = 0.002, and poorer family functioning, t(77) = 4.26, p < 0.001. Family composition (single-parent/couple), having a child with ABI, adaptive coping, and non-productive coping predicted 47.7% of the variance in wellbeing, F(5, 70) = 12.75, p < 0.001. Parental education, having a child with ABI, and non-productive coping predicted 35.9% of the variance in family functioning, F(5, 69) = 7.71, p < 0.001. Adaptive coping may contribute to better family outcomes in paediatric ABI. Paediatric ABI may have a significant impact on the child with ABI and the family, leading to poorer outcomes for some families. This study suggested that parents of a child with ABI use adaptive coping less than parents in the community but do not differ in the use of non-productive coping. Families need long-term targeted support to meet the challenges paediatric ABI presents and may benefit from interventions which actively seek to change parental coping strategies. [ABSTRACT FROM AUTHOR]

This study investigated parent-reported barriers and enablers to establishing sun safety practices with young children (0–4 years; N = 423) living in Australia. An online survey examined parent/child adherence to recommended sun safety practices and barriers and enablers to establishing sun safety practices. Adherence to different sun safety practices varied across age groups. Lack of child cooperation was the most commonly-endorsed barrier while child compliance was the most commonly-endorsed facilitator. Young children's lack of cooperation with sun safety practices represents a major obstacle for parents. In conclusion, the development and testing of family-based intervention approaches to reduce child resistance and promote cooperation is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care. Methods: A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children's Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity. Results: The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities. Conclusions: Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care. What is known about the topic? Children with chronic medical conditions have high rates of unmet need for mental healthcare. Qualitative research has indicated features of mental health services that may be important to consider in service design to address these unmet needs. What does this paper add? A detailed understanding of parents' preferences for features of mental health services for children with chronic medical conditions, including their importance and prediction of uptake under different scenarios. What are the implications for practitioners? Parents preferred services with recommendation from specialists, mental health providers who understand the impact of chronic conditions, lower cost, and shorter wait time. Offering preferred mental health services is predicted to significantly reduce unmet needs and reduce inequalities in care. [ABSTRACT FROM AUTHOR]

Background: Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. Method: The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. Results: More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child's mental health. Between-person baseline predictors of higher intention ratings were parent's prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child's education, lower social support and financial hardship. Conclusion: Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need. [ABSTRACT FROM AUTHOR]

An AB single case design was used to measure the effect of data-based feedback for 6 children in a listening and spoken language early intervention (EI) programme in Australia. Changes in the number of parent-child conversational turns following feedback were measured using an automated language environment analysis system. The perceived value and practicality of the feedback model were also investigated. A functional relationship was demonstrated between the intervention and an increase in the number of conversational turns for 4 of the children. Therapists were able to implement the model with high fidelity and perceived the intervention to be effective in changing parent behaviours. Parents reported the feedback helped them to improve their verbal interactions with their children. This study has provided preliminary evidence that supports the feasibility and the positive impact of data-based feedback in a listening and spoken language EI programme. [ABSTRACT FROM AUTHOR]

Aims This study aimed to examine perceived social norms, the effect of parental drinking on these norms, alcohol use in front of children, and how norms and consumption vary based on child age and gender of the parent. Methods A cross-sectional online panel survey was undertaken with n  = 1000 Australian adults (including 670 parents) aged 18–59 years. The survey assessed: alcohol consumption in front of children; normative attitudes towards drinking in the presence of children; and perceived social norms. Results Overall, 33.9% of parents reported drinking a glass of alcohol each day or a couple of times a week, 18.2% reported getting slightly drunk and 7.8% indicated getting visibly drunk each day or a couple of times a week with their children present. In total, 37.5% reported drinking in front of their children at least weekly. Fathers were more likely to drink in front of children than mothers. Most parents deemed drinking small amounts of alcohol in front of children as acceptable but did not accept drunkenness. Respondents were less concerned about a father drinking one or two drinks in front of their children than a mother. Social expectations were not related to child age, but norms related to others' perceived behaviour were. Conclusions Many parents, particularly fathers consume alcohol in front of their children. There is a need to target health promotion strategies to adults and parents consuming in excess of health guidelines, and to the many parents who are consuming alcohol at higher levels in front of their children. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the views of Australian primary school parents regarding the food and nutrition education (FNE) curriculum. Associations with personal values (Universalism and Hedonism) and demographic measures were also explored. Design/methodology/approach: An online survey was conducted among 787 parents in March 2021. Parents rated the importance of 17 FNE topics. They were also asked about their support for six curriculum improvements and to state their own improvement suggestions. Findings: Parents viewed the "Effect of food on health" and "Food hygiene" as the most important topics. Three FNE components were derived: (1) food safety and preparation, (2) health and nutrition information, (3) food origins and environmental sustainability. The "Food safety and preparation" component score was associated with both universalism-nature and hedonism values but negatively associated with parental education. The "Health and nutrition information" component score was associated with universalism-nature value and main language spoken at home. Lastly, the "Food origins and environmental sustainability" component score was associated with universalism-nature value. The two personal values, universalism-nature and hedonism, were more strongly associated with parents' views of curriculum topics than parental demographic characteristics. Parents had several criticisms of current FNE, including school food environments not resonating with FNE taught in the classroom and that FNE might increase the risk of eating disorders. They also suggested that the FNE curriculum should support both parents and teachers by providing relevant resources and training. Originality/value: Australian parents' views of the importance of FNE topics and how to improve FNE in primary schools have been under-examined. [ABSTRACT FROM AUTHOR]

To explore and describe parental experiences related to the management of mild bilateral congenital hearing loss in children. Using qualitative methods, we conducted semi-structured interviews with parents/caregivers until saturation of themes was achieved. We analysed transcripts using inductive content analysis. Caregivers of children under 3-years-old with mild bilateral sensorineural hearing loss. We interviewed 12 parents. Parental perception of advice regarding hearing aid fitting was varied; almost all children were offered hearing aids. Perceived positives related to hearing aids: feeling empowered that action has been taken; improvements in the child's hearing perception and; facilitation of behavioural management. Perceived negatives of hearing aid use: difficulties with compliance resulting in parental frustration and guilt, damage/loss of equipment, discomfort, parental discord, altered quality of natural sound and potential bullying/stigma. Some parents were ambivalent about the effect of the hearing aids. Where hearing aids were offered and not fitted, there was significant ongoing uncertainty, and the family carried the burden of their decision. There was a wide variation in perceived advice regarding early hearing aid fitting in children with mild bilateral hearing loss. We identified parental perceptions of positive/negative impacts of hearing aid fitting and potential perceived harms from not fitting. [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]

This research looks at speech-language pathologists' (SLPs') knowledge and experiences with Key Word Sign (KWS) training and delivery. The aim of the study was to investigate how KWS is used by Australian SLPs in practice. SLPs' experiences of KWS training and learning needs were explored, and the factors that act as barriers and facilitators of KWS use were identified by the SLPs. A 24-item online questionnaire was designed for the study. The survey was advertised and distributed on various social media platforms for SLPs to access. A total of (105) SLPs across Australia participated in the survey. The data underwent quantitative and thematic analysis. The majority of SLPs reported frequent use of KWS in intervention and adequate knowledge of KWS implementation. The SLPs showed interest in further KWS training. Most SLPs received KWS training through professional development and suggested more training modalities and opportunities. Facilitators and barriers to successful KWS intervention included timing of intervention, client factors, and communication partner factors. This research provides information about current use of KWS among SLPs, along with their opinions and experiences of the barriers and facilitators of using KWS. [ABSTRACT FROM AUTHOR]

Selecting appropriate support goals is a critical part of evidence-based practice when working with children on the autism spectrum and their families. The aim of this study was to explore parents' views and perspectives regarding the communication challenges experienced by their children on the autism spectrum to inform the goal selection process. We conducted an online survey of 105 parents and caregivers in which they shared the three biggest communication challenges for their children (aged 2-8 years) in an average day. Data were examined using content analysis. Seven categories of challenges were identified including everyday situations (general and specific), expressive and receptive language (general and specific for each), and other skills and behaviours. Participants varied substantially in how they conceptualised goals. Clinicians should recognise and account for the fact that parents' understanding and prioritisation of their children's communication needs vary when working together to formulate goals. [ABSTRACT FROM AUTHOR]

Introduction. The success of family-based community programs for childhood obesity may be increased by promoting social-cognitive factors that influence motivation and participant engagement. Incentivizing behavior can potentially enhance engagement and encourage behavior change. This research investigated motivators to engagement with a multicomponent incentive-based strategy to improve attendance and health-related behavior change in a family community-based weight management program for overweight and obese children. Method. Qualitative analysis combining; demographic data (n = 512), survey of parents (n = 273), and stakeholder (n = 10) and family interviews (n = 24). Participants were selected from program providers and families participating in an Australian community weight management program during a randomized controlled trial (n = 512 children). Maximum variation sampling (demographics and group characteristics) and inductive thematic analysis were used. Results/Conclusion. Four factors influencing engagement were (1) personal value, (2) achievement, (3) support, and (4) overwhelm. These themes corroborated with social-cognitive factors, fostered by a combination of behavior change components in the program that increased participant accountability and intrinsic motivation. Focusing on autonomous goal planning with parental involvement, tracking of goals, and reviewing of goals may complement existing strategies in child-focused treatment programs. Low-value noncash incentives linked to goal setting for encouraging healthy eating and physical activity were well accepted and may enhance family engagement and attendance. [ABSTRACT FROM AUTHOR]

The topic of professional self-disclosure has been subject to uneven levels of attention in the social work literature. Although many writers and researchers have addressed the topic in the context of clinical social work, there has been limited dedicated attention to its use and role in routine practice in child protection and child welfare settings. This article is concerned with a specific type of self-disclosure: what social workers say to the parents they work with about whether they themselves are parents or not. Drawing on interview material from a research study concerned with how children's services professionals experience the suffering of parents, it explores the psycho-social dynamics of social workers investing in different positions about making or refusing to make disclosures about their parental status. This allows for differentiated insight into the contexts that surround parental status disclosure and highlights how decision making around whether and what to disclose can be led more by anxieties and concerns about the maintenance of a particular professional identity than deliberation about potential benefits to parents and the working relationship. [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]

This study aimed to explore the most prevalent causes and consequences of maladaptive parent-adolescent conflict from the perspectives of Australian psychologists and other family clinicians. We also queried whether these professionals have observed events or times that exacerbate parent-adolescent conflict. A cross-sectional survey was used to collect data from one hundred and thirty-seven clinicians working in Australia with parents and adolescents. Data were collected via an author-developed, online survey and frequencies were reported. Daily issues of family life (e.g., chores) and relationship readjustment were reported as the most prevalent themes causing parent-adolescent conflict, with problems at school reported as a theme resulting from conflict. Mental health issues in parents and adolescents were reported to (a) be common causes of conflict and (b) worsen after conflict. Trauma and domestic and family violence were identified as additional causes not well represented in existing research. Respondents reported Christmas as a time when conflict was exacerbated. Increased awareness amongst clinicians of the likelihood of encountering these issues in their work with families will support competent risk assessment, crisis management and service delivery. Implications of findings for future research on parent-adolescent conflict during specific years of adolescence, training of clinicians and risk management in clinical practice are discussed. KEY POINTS What is already known on this topic: Conflict with parents increases during the adolescent years. Parent-adolescent conflict can be caused by a wide range of factors, and have a range of adaptive and maladaptive consequences. Parents and adolescents experiencing maladaptive conflicts often seek support from family clinicians. What this topic adds: A current exploration of the causes and consequences of parent-adolescent conflict that are most prevalent. The perspectives of the family clinicians who support conflicted parents and adolescents, but have been underrepresented in existing research. Inform early-career clinicians who support families of the most prevalent factors they may encounter in their work, improving risk assessment and crisis management following a conflict. [ABSTRACT FROM AUTHOR]

Parents from individualist cultures (those focused on autonomy of individuals; that is, Australian) may view their autistic children differently compared to parents from collectivist cultures (where community needs are valued over an individual's, that is, South-East Asian cultures). As most research on autism and parenting has been undertaken in Western individualist cultures, knowledge of parenting beliefs and mental health within collectivist cultures is lacking. We compared the mental health, quality of life, well-being and parenting sense of competency between families raising an autistic child from two groups: 97 Australian parents and 58 parents from South-East Asian backgrounds. Children from both groups were receiving the same community-based early intervention. No group differences were found on the measures of mental health but, when compared to Australian parents, parents from South-East Asian backgrounds reported higher well-being and less impact on their quality of life resulting from their child's autism-specific difficulties. Furthermore, a positive association between well-being and quality of life was only observed for South-East Asian parents. Hence, the views of, and responses to, disability for South-East Asian parents may act as a protective factor promoting well-being. This novel research indicates that culture plays a role in parenting autistic children and highlights the need to accurately capture cultural background information in research. We know that parents of autistic children experience poorer mental health and lower well-being than parents of non-autistic children. We also know that poorer mental health among parents of autistic children has been observed across different cultures. Most research focuses on Western cultures, so we know little about parental mental health and well-being of parents from different cultural backgrounds; yet, it is likely that cultural background contributes to how parents view their child's condition and respond to the diagnosis. Here, we compared mental health, quality of life and well-being between families raising an autistic child from Australian backgrounds to families from South-East Asian backgrounds. All children in the current study were receiving the same community-based early intervention. When compared to the general population, parents had poorer mental health overall, but there were no differences between the two groups of parents. However, parents from South-East Asian backgrounds reported higher well-being and fewer difficulties associated with their child's autism. These findings suggest that cultural background likely influences not only parent's view of, and response to, their child's autism, but also their own sense of well-being. As researchers and clinicians working with families of autistic children, we should more explicitly consider family's cultural background within our work. [ABSTRACT FROM AUTHOR]

In this study we aimed to investigate the usability and acceptability of an online training program, Language Together, which was developed for caregivers of children aged 5 years and younger, with, or at risk of language disorders. Language Together presented material on language development and strategies to facilitate language development using a multimedia website. Language Together was developed using the Wix.com platform and was made available online. Twenty-nine caregivers and seven professionals completed both the training and pre-post questionnaires which aimed to evaluate the usability and acceptability of the program. Caregivers and professionals rated Language Together as a useable and acceptable program to develop knowledge about language development. Participants found the online format easy to access and could complete the training at a time and location that was convenient. Most caregivers and professionals identified that they enjoyed the range of resources included in the training especially the video materials. Online training programs can be a useable and acceptable method for providing information about language development. [ABSTRACT FROM AUTHOR]

People from refugee backgrounds can experience identity issues living between two cultures. Identity development for adolescents and youth, is further complicated by simultaneously having to navigate between childhood and adulthood, and expectations of parents, ethnic community, and host society. Objective: This study with refugee-background youth and adults, explored participants' perceptions of being Australian and their sense of belonging, after migrating to Australia. Method: Study sample included a multiethnic sample of 79 participants: 46 refugee background youth, 15-26 years and 33 parents or significant family members residing in South Australia. Participants had migrated to Australia from the Middle East, South Asia, or Africa, between 1 and 15 years ago. We used a semi-structured interview protocol and data-based thematic analysis to collect and analyse individual interviews. Results: We identified the themes of acceptance, ambivalence, confusion, and rejection of an Australian identity in both youth and parent interviews, although youth interviews were more eloquent and nuanced. While most participants accepted an Australian identity and considered Australia their "home" for reasons of safety, opportunities and support available to them, others opted for a dual identity combining elements from Australia and heritage country. A few participants rejected an Australian identity but still considered Australia "home". KEY POINTS What is known about this topic: Refugee-background people generally do not settle in the same way as other migrants due to pre-migration trauma and stressors associated with the resettlement process. The sociocultural and psychological challenges of negotiating acculturation are another important factors impacting on settlement outcomes for refugee-background migrants. Acculturation entails a degree of identity uncertainty, conflict and the need for identity reconstruction. What is new about the topic: Identity development and reconstruction presented on a continuum from acceptance of an Australian identity including a dual identity, ambivalence and confusion, to rejection of an Australian identity. The vast majority of refugee-background youth and parents considered themselves "Australian" and that Australia was their "home". The perceptions of racism and discrimination affected participants' identity development and reconstruction after resettlement although their resettlement outcomes appear to be minimally impacted. [ABSTRACT FROM AUTHOR]

In Australia, school-based immunisation programmes (SBIP) provide Human Papillomavirus (HPV) vaccinations to secondary school students. However, despite such free programmes, around 20% of girls and 25% of boys do not complete all doses. This formative study identified barriers and enablers to vaccine completion. Online surveys were conducted with senior school administrators and nurses from Western Australian secondary schools across all three school sectors. Year 8 students participated in focus group discussions. Parents participated in one-on-one interviews (n = 22). Administrators were supportive of vaccination and the SBIP. Nurses and administrators perceived lack of parental awareness, issues around consent and school absenteeism as the main barriers to completion. Parent and student knowledge concerning HPV, the HPV vaccine and immunisation in general were low. Despite this, students and parents were supportive of the SBIP and wanted the opportunity to learn more about HPV, the vaccination and immunisation in general. There are opportunities for targeted school-based work to increase awareness and provision of consent. [ABSTRACT FROM AUTHOR]

The introduction of augmentative and alternative communication (AAC) systems can enhance the participation of young children with complex communication needs. However, existing literature suggests that the knowledge, skills, and attitudes of the child's parent may prevent ongoing use of the AAC system. Therefore, this study aimed to explore parent perspectives on the contribution of factors associated with the family unit to the rejection or abandonment of an AAC system for their child with complex communication needs. Parents of children with complex communication needs who had previously rejected or abandoned an AAC system (N = 12) participated in a semi-structured interview. Thematic analysis of the interview data was completed. Analysis revealed four themes which captured family factors contributing to the rejection and abandonment of AAC systems: (a) parents lacked the emotional readiness and resilience to implement AAC, (b) implementing AAC was extraneous work for parents, (c) the child did not use their AAC system for communication, and (d) parents were not satisfied with the AAC system itself. SLPs must be aware of and account for these factors to enable the successful introduction of AAC systems. SLPs may increase the acceptance of AAC systems by working with a multidisciplinary team to support parents through their grief and implement strategies to build their resilience in the face of adversity. SLPs need to acknowledge the existing demands on parents when planning AAC intervention and support parents to integrate AAC systems into their daily routines. SLPs must carefully consider the child's motivation, sensory profile, and physical abilities as well as parent preferences when prescribing an AAC system. These considerations will give the child and parent the best opportunity for success with the system and consequently reward parents for the effort they have invested. [ABSTRACT FROM AUTHOR]