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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]

Objectives: This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia. Design: A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis. Results: Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology. Conclusion: The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds. [ABSTRACT FROM AUTHOR]

To understand the pathways of children with disability participating in gymnastics in Victoria, Australia. A sequential explanatory mixed-method study design was used. Participants completed an online survey, with selected participants purposively invited to undertake semi-structured interviews via videoconference. Quantitative survey data was analysed using descriptive statistics with preliminary findings informing the invitation of interview participants and refinement of interview questions. Qualitative survey and interview data were analysed together using thematic analysis to create themes. Data was combined to create a conceptual model. Fifty-eight parents consented to participate in the study with eight interviews conducted. Key themes were: (1) Tailored, accessible, supportive environments and programs make a difference, (2) An explicitly inclusive club culture helps young people get and stay involved, (3) Coach knowledge about engaging children with disability is valued, (4) Enjoyment, recognition, and achievement facilitate ongoing participation, and (5) Gymnastics has physical and social benefits for children with disability. The findings inform a conceptual model that describes three key stages along a pathway to participation including; choosing gymnastics as a sport, selecting a club, and ongoing participation. To our knowledge, this is the first study to explore participation of children with disability in gymnastics in Australia. These findings provide guidance to those supporting children with disability to participate in gymnastics (e.g., policy makers, club owners, coaches, and allied health professionals) regarding creating more inclusive environments and experiences at each stage of participation. This study furthers our understanding of the impact of childhood disability on participation in sport and recreation, with a focus on gymnastics. A combination of accessible environments, inclusive club cultures, recognition and enjoyment, and knowledgeable coaches facilitated participation in gymnastics. Parents perceive gymnastics to have physical and social benefits for their child. A conceptual model has been developed based on the findings to support gymnastics clubs and assist rehabilitation professionals to understand the challenges and enablers to participating in gymnastics. [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 mental health of young people in youth sport has received growing academic attention and sporting clubs are identified as important settings for prevention and early intervention. Despite this, very few studies have explored the perceptions of multiple stakeholders about youth sporting clubs as spaces for mental health awareness, education, and training. The purpose of the study was to understand the capacity of youth sporting clubs1 to become a site for general mental health support and explore parents, coaches, club leaders and youth participants perceptions about their sporting club's readiness for mental health awareness, education, and training initiatives. Using an Interpretive Description (ID) research methodology, 26 participants (parents, youth, club leaders/coaches) involved in community-level youth sport participated in a qualitative telephone interview. Data was analyzed thematically, leading to the construction of three themes about the barriers for building and maintaining a culture of mental health support in youth sport: (a) initial resistance, (b) teething issues and (c) turbulence. The themes reflected perceptions about varying levels of club readiness for meaningfully supporting positive mental health and indicated that many youth sporting clubs may find it difficult to sustain long-term, positive change. The study suggests that while sport can be a promising avenue to promote positive mental health, it is not without multiple forms of resistance, which if not navigated, may discourage efforts to establish and maintain club settings as sites for mental health, education, awareness, and first aid training. Implications for the field are discussed. Lay Summary: Parents, youth sport participants and club leaders/coaches were interviewed for the purpose of understanding their views of youth sporting clubs' capacity to become a site for mental health support. The thematic findings suggest that clubs are differentially equipped to support meaningful cultural change surrounding mental health and sport. Clubs seeking to become a site for mental health support encounter various barriers and therefore display differential levels of "readiness" for change. To meaningfully and sustainably create clubs that support mental health, additional intervention methods are necessary to support mental health education, awareness-raising activities and first aid training in youth sport. [ABSTRACT FROM AUTHOR]

Autistic students experience elevated rates of school exclusion, whether this be through expulsion, suspension, informal suspension, refusal of enrolment, or school refusal. This exclusion can come about from a range of factors, including sensory or cognitive overload, a lack of training in neurodiversity for teachers, an absent sense of safety by the student at school, or poor attitudes towards the inclusion of autistic students in schools. The impacts of this exclusion on parents can be logistical, financial, and psychological, with a range of mental health outcomes. This Australian qualitative study presents case studies of seven parents of autistic students, as well as four themes that capture the recommendations of parents to address school exclusion. The findings demonstrate that parents experience stress in finding a suitable school for their child, working with staff to meet the needs of the child, and attempting to maintain employment and other commitments when the child experiences exclusion. Parents recommend greater acceptance of autism by education systems, better communication and use of neuro-affirming language, the option for flexible learning, and individualised support by the school for the student. [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]

Background: The COVID-19 pandemic has created many challenges for families across the world, with those who have recently had a baby particularly vulnerable to increased stress Study Aim: The current study aimed to explore the experiences of the COVID-19 pandemic of families who have recently had a baby in Melbourne, Australia. Methods: Interviews were conducted with sixteen parents participating in a family-based intervention during early parenthood and seven clinicians who delivered the program. Results: Parents and clinicians described impacts of the pandemic on parent and family functioning included mental health concerns, stress and irritability, feelings of isolation, and increased relationship tension. Parents discussed coping strategies used during the crisis, including activities with their family, connecting with others, trying to stay positive, and self-care activities such as spending time outdoors. Both parents and clinicians acknowledged the importance of mental health and parenting support during and following the pandemic, and for these services to be promoted and easily accessible. Discussion: The study highlights the mental health and parenting support needs of families during times of crisis and emphasises the importance of early intervention for families exhibiting poor communication and relationship tension. [ABSTRACT FROM AUTHOR]

Background: Routine height and weight screening of children accessing health services in South Western Sydney Local Health District (SWSLHD) was implemented to address childhood obesity. This qualitative study aims to explore the views of parents/carers regarding the role of healthcare professionals (HCPs) in measuring their child and raising the issue of weight when accessing health services. Methods: A qualitative study using semi-structured interviews was performed. Parents/carers of children who had their height and weight measured at a SWSLHD facility were invited to participate. Purposive sampling was used to select parents/carers of children from different body mass index (BMI) categories and different health settings. Interviews were digitally audio-recorded and transcribed verbatim. The de-identified data were coded and analysed thematically using NVivo. Results: A total of 24 semi-structured interviews were conducted. Of these, 14 were of parents/carers of children who were outside the healthy weight range. Three main themes were identified: parental perception of their child's weight, parental expectations, and parental challenges. We found that many parents/carers were unaware of their child's weight status and often underestimated it. Many were open to receiving advice and resources as long as it was addressed professionally and respectfully. Conclusions: Contrary to the views of some health professionals, parents/carers want to know their child's weight status. They valued the information and advice provided by well-trained clinicians who are confident to raise the issue of weight with parents/carers. Healthcare professionals (HCPs) are often reluctant to perform height and weight measurements or raise the issue of weight. In contrast, parents/carers often expect weight concerns to be addressed during episodes of care. Increasing HCP awareness of parents'/carers' views and expectations in the prevention and management of obesity may lead to clinical practice improvements and provide a first step in addressing excess weight gain in children. [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]

Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy. [ABSTRACT FROM AUTHOR]

Immigration brings particular challenges to older Chinese immigrants' wellbeing because they make a new home in a foreign country. Based on 30 semi-structured in-depth interviews, this study aims to understand the immigration history of this specific group and unravel the complex links between family relationships and wellbeing. Four themes emerged from the interviews. First, the decision to immigrate is the result of the combined influence of family values, affinities and the need for aged care. Second, after immigration, housework normally negatively influences their wellbeing. The third theme pertains to the interactions amongst family members. The final theme shows that Chinese immigrants' perceived wellbeing is influenced by family relationships, an independent lifestyle and social networks. This research highlights older Chinese immigrants' complex feelings of family commitment, personal values and the need for aged care. Practical implications for policymakers to better facilitate this group's wellbeing are provided. [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]

Fly-in/fly-out (FIFO) work practices have become common place in Australia over the past two decades. Research has documented the personal impact of these work practices, but little peer-reviewed research is available on the family impact of this work. The study aimed to better understand (1) the impact of FIFO work arrangements on children, parents and relationships; (2) strategies parents use to manage the home-away cycle; and (3) preferences for parenting support. Interviews were conducted with six FIFO workers and 15 partners of FIFO workers with at least one child aged 2–12 years. Inductive thematic analysis revealed six themes: effects on children; effects on family relationships; effects on parenting; managing transitions; managing separations; and the need for flexible, tailored parenting support. The findings provided important insight into the experiences of working FIFO with a family and can inform the development of parenting support targeted at FIFO families. [ABSTRACT FROM AUTHOR]

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

Practising self-care is vital for foster carers to cope with the stresses of the caring role, provide the best care possible and continue in their task. This current study contributes to emerging research on the self-care practices of foster carers in Australia and worldwide. It used an exploratory design, surveying 148 foster carers about their self-care and conducting individual, semi-structured interviews enabling nine of them to elaborate on their self-care experiences. The results indicate that while the participants sometimes engage in self-care and value it as a way of maintaining their wellbeing and increasing their caregiving capacity, they face several barriers to doing this. These include the multiple responsibilities of the foster carer role, children's commitments, employment and finances. Facilitators of self-care include social and family support, contact with other carers and carer respite. Foster care agencies and the out-of-home care system should aim to meet the self-care needs of carers by providing increased support, resources and education. Plain language summary: Self-care is important for all individuals and vital for those providing care to children in out-of-home care who often have complex and challenging needs. This study asked 148 foster carers in Australia what they did to practise self-care. Foster carers demonstrated an understanding that self-care is important and a desire to practise regular self-care. However, they identified many barriers to engaging in self-care. This article explains why and how foster carers practise self-care, what prevents self-care from occurring and how to improve foster carers' self-care practices. [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]

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

This study aimed to explore how foster carers conceptualize and engage in self-care using interviews with 8 participants. Results suggest that self-care practices are an important component of maintaining the physical and mental health of foster carers, preventing burn-out and enhancing therapeutic parenting practices. Several barriers to self-care are identified, including systemic barriers as well a foster carers' own feelings of guilt for prioritizing their own needs. Results indicate that self-care requires a collaborative approach between foster carers and the broader child welfare system. Improved self-care specific training, resources and coaching from agencies were also identified as important outcomes. [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]

Mothering and motherhood can be a very challenging experience in the 21st century, where cultural pressures, on the one hand, and health experts' regular parenting surveillance, on the other, continue to influence mothering decisions and practices. The socially constructed "good mother" discourses and associated pressures/influences can be amplified for vulnerable mothers who may feel marginalized from or judged by the broader society. This article presents findings from a study that involved interviews with ten young mothers and 12 staff working at a leading family welfare agency supporting young parents in Melbourne, Australia. The study examined how digital technology could promote a sense of agency for vulnerable mothers as well as barriers and enablers of accessing digital knowledge and online parenting support. In addition, the study explored how technology could assist community organizations' staff in helping their clients better. This paper argues that, overall, digital technologies can positively influence the experience of mothering and can empower vulnerable mothers by increasing their access to various sources of support. Furthermore, our findings suggest that technology can enhance community and family service providers' practice, opening possibilities for a more supportive relationship with clients by empowering them and increasing agency over their situation. [ABSTRACT FROM AUTHOR]

Beliefs, practices and perceptions of early child development informing school readiness were examined for parents of preschool‐aged children living in one multicultural suburb in Western Sydney, Australia. Survey data (N = 87) and semi‐structured interviews (N = 52) with parents were collected in public spaces (e.g., parks, libraries, church halls and community centres) in mid‐2019. Participants, primarily migrants of South Asian background, believed children learn through practical activities, prioritising academic and social development, with less focus on emotional development and communication skills. Parents' approached school readiness through the engagement of children in shared activities that maintained traditional cultural practices while simultaneously seeking to create community connection. Raising awareness of and engagement in both formal (e.g., early education services) and informal services (e.g., playgroups, library groups) could provide migrant and refugee parents with supportive networks in their local communities. Offering subsidies for attendance at early childhood programmes may reduce costs and encourage attendance, particularly for outdoor activities, helping to establish support networks for parents and children before starting primary school. These connections may provide families with a pathway for the identification and access of other local services and supports for their children. Programmes could also offer a platform for raising parental awareness of a holistic approach to child development and its importance for school success. Incorporating multicultural activities into early childhood programmes and settings could further assist parents in maintaining traditional cultural ties while creating essential local community connections. [ABSTRACT FROM AUTHOR]

Autism assistance dogs (AADs) increase safety for children with autism and their families. Autism assistance dogs can also decrease familial stress and the isolation which families may experience due to fear for their child's safety and judgement from others within the community. Currently there is a paucity of literature on parents' experiences of AADs. Therefore, this study aimed to develop a rich understanding of parents' experiences of owning an AAD. A mixed methods design was utilised, with a qualitative descriptive design and the use of occupational mapping. Eight families were recruited through an Australian AAD programme and participated in semi‐structured in‐depth interviews throughout 2017. The interviews were analysed thematically. Mobility in the community before and after introduction of the dog was measured using occupational mapping. Families plotted on Google Map printouts the places they frequented before and after placement of their dog. Five major themes emerged from the analysis of the interviews: freedom through restraint; expanding our world; a calming/sensory tool (AAD); "at the end of the day they're dogs"; and, friendship and personal growth. The occupational maps demonstrated a median increase of 8.5 more places and 20.50 km further travelled from home after having the dog for over a year. Families with an AAD experienced an expanded world for the child and their family. Families experienced freedom in the places they could go, decreased isolation due to the safety which the dog provides. Occupational mapping supported the qualitative data, showing increased mobility and decreased isolation of the family. The paradox of freedom through restraint is a new and key finding which requires further exploration. The results provide support for funding and increased awareness of AAD programmes. Future longitudinal comparative studies are needed to explore the long‐term impact of AADs on the child and family. [ABSTRACT FROM AUTHOR]

Participation in high-quality early childhood education and care (ECEC) benefits children and society. Policy recognition of this manifests through government subsidy strategies to increase ECEC access in the years immediately preceding school. Yet despite this action, many children do not receive the recommended amount. This study utilizes a mixed-methods design to investigate ECEC participation barriers and facilitators in three Australian communities. Parents and service providers completed online questionnaires (45 parents, 63 providers) and semi-structured interviews (21 parents, 16 providers). Results showed that issues related to both direct (e.g., fees) and indirect (e.g., travel) costs are particularly important barriers for families, and are well-recognized by providers. A range of factors were also considered important for facilitating participation (e.g., effective promotion of the benefits linked to high-quality play-based learning in formal settings, professional training of staff). Findings demonstrated the ecological complexity of participation. Strategies to address barriers and harness facilitators are required across multiple levels. Highlights: Participation in high-quality early childhood education benefits children. Many children do not receive the recommended dose of early childhood education. Parents and providers see various participation costs as important barriers. Providers may underestimate barriers relating to maternal role beliefs. Promotion of child benefits and staff training may facilitate participation. [ABSTRACT FROM AUTHOR]

Objectives: This pilot study aimed to explore the perceived benefits of a new children's sensory garden in a healthcare centre in south-eastern Melbourne that provides specialised care, support and guidance to parents. Methods: A mixed-method research design was employed in this study comprising a combination of quantitative (surveys) and qualitative (interviews) data collection methods. A total of 19 staff and 36 parents completed surveys relating to their experiences in the new garden. Results: The staff members and parents surveyed were found to use the new children's garden on a regular basis and suggested that the new garden provided them with an opportunity to escape and feel calmer and had positively impacted on their interactions with their child. Interviews were also undertaken with four staff members who indicated that they believe the new garden is affording them perceived personal wellbeing benefits and that the activities in the new garden led to better perceived outcomes for families. Conclusion: The perceived benefits reported provide support for the development of sensory gardens at other similar healthcare facilities. What is known about the topic? The restorative benefits of gardens and other natural features are well known. What does this paper add? Pilot study findings as to whether there are any perceived benefits of accessing a children's sensory garden in a healthcare setting. What are the implications for practitioners? The inclusion of children's gardens could be considered at healthcare facilities to promote wellbeing of staff, patients and visitors. [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]

Purpose: Standardised testing tools within an Aboriginal Australian context have been found to produce inaccurate results due to language and cultural differences. The primary aim of the study is to compare Aboriginal children's scores in urban NSW across two language assessment tools: the Early Language Inventory (ERLI) and the Australian English Communicative Development Inventory, short form (OZI-SF). These tools are vocabulary checklists for children aged approximately 12–30 months. OZI-SF is an Australian tool for mainstream use and ERLI has been developed with and for Aboriginal families, but not in urban contexts, so its suitability there is unknown, given the great cultural and linguistic diversity among Aboriginal people across Australia. The second aim is to identify which tool is more culturally appropriate for urban Aboriginal families through parent perspectives. Method: Overall, 30 parents (of 31 children) participated in the study to complete the ERLI, and 14 parents from this sample completed both the ERLI and OZI-SF and interviews to explore child scores and parent perspectives, in a mixed methods approach. Result: Aboriginal children (N = 14) scored higher on the ERLI than the OZI-SF. Gender and age were significant contributors to the scores as scores were higher for older children and higher for girls than boys. In answer to the second aim, four themes emerged to explain parental perspectives and their preference for the ERLI, which supported connection to culture and language. Conclusion: Findings have implications for paediatric language assessments with urban Aboriginal families in clinical, educational and research settings. [ABSTRACT FROM AUTHOR]

Teletherapy services are being increasingly provided by allied health professionals to address major inequities of access. While clinical outcomes and stakeholder satisfaction are crucial for paediatric teletherapy's continued viability, processes for increasing parent/caregiver satisfaction, and for modifying aspects of caregiver engagement to improve outcomes, are under‐researched. Studies of in‐person therapy have shown that engagement, satisfaction and outcomes are influenced by the development of therapeutic alliance. This study investigates influences on parents' engagement with a teletherapy program and their therapeutic alliance with the therapist. Using a qualitative approach, data were analysed from semi‐structured telephone interviews with six parents in rural New South Wales, whose children had completed paediatric teletherapy programs provided by a psychologist, speech pathologist or occupational therapist. Parents described factors that affected aspects of their engagement and alliance. Thematic analysis with constant comparison was used to determine the themes of the interviews, which were (a) initial engagement, (b) collaboration and (c) rapport. The themes demonstrate that parents were evaluating the efforts the therapists were making in (a) communicating, (b) truly partnering with them, both being elements of collaboration and (c) building rapport with them and the child. A conceptual model, Parent And Caregiver Evaluation Cycle In Teletherapy (PACECIT), is proposed by the researchers to explain how parents evaluated the therapist to judge the current state of a personal relationship and to judge the effectiveness of a collaborative relationship, both influencing the therapeutic alliance and motivation for engagement. The findings emphasise the importance of fulfilling parent/caregiver expectations for clear and frequent communication, and discussion of their ideas. Also important is the development of therapeutic alliance through utilising parents' observations of non‐verbal communication to maintain an effective rapport and enhance engagement. [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]

The introduction of a National Disability Insurance Scheme (NDIS) in Australia has changed the basis of service provision for people with disability. This mixed-methods study presents the experiences of parents of children with hearing loss during national rollout of the NDIS. Surveys were completed by 100 parents, with 57 parents reporting their child received NDIS funding. Individual interviews of seven parents in different locations provided further information. Between-group comparisons were made and regression analysis examined the influence of parental disadvantage on NDIS experiences. Qualitative data were analysed for themes and findings were triangulated. The NDIS has improved services for some children with hearing loss but initial access and ongoing navigation can be challenging for others. Barriers included a complicated system, planning delays, poor communication and uninformed National Disability Insurance Agency (NDIA) staff. This study suggests areas of refinement and further investigation that may improve services for children with hearing loss. Parents of children with hearing loss in Australia had difficulty accessing the National Disability Insurance Scheme (NDIS) due to poor communication and delays. Parents reported the NDIS system was challenging and felt they needed high levels of education and advocacy skills to navigate the system and prepare information to justify necessary disability supports for their child. Parents were concerned that disadvantaged families would not receive adequate supports for their child with hearing loss due to the complexity of the NDIS. This small-scale national study indicates that recent and upcoming changes to the NDIS should be evaluated to ensure children with hearing loss can access equivalent funding packages and services regardless of family circumstances. [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]

Children undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to pain due to the intensity and toxicity of this treatment. An instrumental case study design of two qualitative phases was conducted to examine the pain experiences of hospitalized children during HSCT therapy and how contextual factors related to the pediatric HSCT environment influenced their experience of pain. The Social Communication Model of Pain provided the conceptual framework for the study. In Phase 1, semi-structured interviews were conducted with parents of a child undergoing HSCT therapy at two time points. Phase 2 was conducted as a naturalistic observational study of the clinical care provided to children and semi-structured interviews with health-care providers. Children experienced complex and multifaceted pain with physical, psychological, and contextual contributors. Understanding the many factors contributing to the child's pain experience can inform strategies to improve the management of pain during HSCT therapy. [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]

Access to medical care is significant for many transgender young people and their families, which involves interactions with healthcare professionals. While a trans affirming model is used across Australian paediatric gender clinics, this does not automatically mean that all transgender young people and their parents experience the care they receive as affirming. This article considers the experiences and views of transgender young people (aged 11–17) and their parents in relation to healthcare professionals inside and outside of gender clinics in Australia. Ten qualitative interviews were conducted with parent–child dyads in two Australian states. Key themes relating to healthcare professionals were: differing levels of healthcare professional knowledge and affirmation, quality of service is dependent on individual healthcare professionals, and lack of connected services and referral pathways. The discussion explores specific issues arising from the findings that suggest implications for training for healthcare professionals so as to be better equipped to provide trans affirming clinical care. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences of Australian parents caring for a child using intensive insulin therapy in the early primary school setting to identify facilitators of this therapy and implications for parents. Background: Young children with type 1 diabetes require adult support when administering insulin in the early primary school setting, yet availability of school support, such as from nurses, is inconsistent across Australia. This increases the burden on parents and in some circumstances, insulin is avoided at school. Study design and methods: This study was a qualitative research design using narrative inquiry. Mothers (n=14) from six Australian states/territories with children attending Government, Catholic and Independent schools participated in semi-structured telephone interviews between December 2014 and September 2016. Narrative analysis was used to interpret the interview data. Results: Nine narrative threads told the collective story of mothers' experiences supporting their child with intensive insulin therapy at school. Facilitators of intensive insulin therapy were collaborative partnerships between parents and school staff, diabetes education for school staff, reasonable adjustments for integrated care and the use of continuous glucose monitoring systems. Implications for mothers were the stigma of advocating, being worried about their child's safety in other people's care, restricted employment, wanting their child to be like everyone else, and providing 24/7 care behind the scenes. Despite these challenges, all children received intensive insulin therapy at school. Discussion and conclusion: The findings of this study indicate that the Australian education system lacks appropriate health support structures required for children with type 1 diabetes. In order to facilitate diabetes care at school non-nursing staff are trained to administer or supervise insulin and the overall responsibility is transferred onto parents. Implications for policy and nursing practice: Nurses working as diabetes educators need to be aware of the burden on parents and advocate for more supportive practices to facilitative intensive insulin therapy in the early primary school setting. Parents, in collaboration with health and education departments, should demand the allocation of appropriately qualified school nurses to legally provide high quality diabetes care that children are entitled to. If current practices, dictated by insufficient resources continue, the Australian Government will make the assumption that existing systems are adequately meeting the needs of students with type 1 diabetes. [ABSTRACT FROM AUTHOR]

To understand parents' experiences of evidence-based assessment by health professionals for their child with cerebral palsy. A qualitative interpretive description study was undertaken. Primary carers of children with cerebral palsy (aged 3–18 years) from south-eastern Australia were invited to participate. Face-to-face interviews were held using a semi-structured topic guide and data analyzed inductively. Credibility was ensured through: journal reflections; co-author review; audit trail; and, participant member-checking. Fourteen parents of children with cerebral palsy, representing Gross Motor Functional Classification System levels I–V, participated. Six themes emerged: (1) Protection; (2) Positively Framed; (3) Bridging the Gap; (4) Involvement; (5) Finding Worth; and (6) Trust. Central to parents' experience was protection of their child's identity and personal self. Assessment can be emotionally confronting, at any stage. Representing the child positively and highlighting possibilities was deemed essential. Parents' involvement ranged from being overlooked spectators to being instigators of assessment. Evidence-based assessment was worthwhile when relevant to parents' direction and family context. The researchers' interpretive description generated a schema and metaphor—the Steering Wheel for Collaborative Assessment. A strengths-based approach to diagnosis and assessment is essential. The resulting interpretive description may assist health professionals align evidence-based assessment practices with family-centred care. Parents of children who have cerebral palsy describe having to protect their child's identity and representation, and their own personal well-being, through evidence-based assessment and diagnostic processes. Involving parents in the process of evidence-based assessment and adopting a strengths-based approach is essential. The interpretive description developed—the Steering Wheel for Collaborative Assessment—may assist health professionals to implement evidence-based assessment tools in ways consistent with family-centred care principles. [ABSTRACT FROM AUTHOR]

As the popularity of using dogs to assist individuals with disability grows, there is a need for increased understanding of assistance dog handlers' experiences of living and working with their dog. This is particularly pertinent to first-time handlers and during the initial placement period, where the handler and assistance dog, and the relationship forming between them, may be extremely vulnerable. The aim of this study was to better understand first-time assistance dog handlers' experience of the placement period, especially any challenges that they experience. Semi-structured interviews were conducted with two youth and five adult handlers, and one parent of a young handler, recruited from three Australian assistance dog organizations. Interviews were conducted 1 month following the initial acquisition of an assistance dog. Meleis' transitions theory was used to develop a better understanding of the transition process for first-time handlers. Inductive content analysis identified various challenges that first-time handlers experience throughout the transition period. These included: the initial response to living with the assistance dog; renegotiating relationships and social interactions; and, adjusting expectations regarding the assistance dog's behavior and capabilities. First-time handler experiences indicate a need for assistance dog organizations to develop initiatives to further assist their handlers through a smooth transition into assistance dog ownership. Integrating an assistance dog into a first-time handler's life is a long process full of challenges. Provider organizations and other support members markedly impact the ease of transitioning an assistance dog into a handler's life. Organizations should be aware of the role they have and employ strategies to create as smooth a transition as possible. Support from other support members is crucial to ease the challenges experienced. [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]

This study aimed to describe the experiences of autistic people who had interacted with police in Australia in the previous 5 years. Fifty autistic adults and 61 parent/carers completed a questionnaire and 30 participants took part in an interview. Participants were most commonly interacting with police in the context of seeking assistance or as victims of crime. Autistic adults were largely unsatisfied with their interactions and reluctant to disclose their autism. Parent/carers reported significantly higher satisfaction than autistic adults and incidents involving children were rated more highly than those involving adults. Suggestions for improved interactions included increased autism awareness amongst police and use of appropriate accommodations. Areas for future research in relation to the evaluation of police training is discussed. [ABSTRACT FROM AUTHOR]

Co-participation in physical activity may be important for helping families with young children meet physical activity recommendations. Yet, little is known about what families perceive to be the benefits, barriers and facilitators of co-participation. This study explored (i) parents' perceptions about physical activity and possible benefits of family-based co-participation in physical activity, (ii) their perceived facilitators and barriers to co-participation and (iii) their recommendations for improving co-participation within their community. Fifteen parents (14 mothers, 1 father) of 2- to 4-year-old children residing in Western Sydney, Australia, participated in one-on-one interviews between September 2016 and January 2017. Interviews were audio-recorded and transcribed verbatim. Four main themes and seven sub-themes emerged from the thematic analysis of the interview data. When parents were asked to reflect on their understanding of physical activity, they discussed a range of well-known activities (e.g. active play, active transport) and also reported 'anything but screen time'. The major benefits parents reported about co-participation were spending quality time together, improving children's general health and well-being and the development of physical skills. Social (e.g. social networks, negative stereotypes) and environmental (e.g. home space, neighbourhood design, shading) facilitators and barriers were identified, yet their impact on co-participation often varied depending on the presence (or lack thereof) of other factors in the physical or social environment. Key recommendations suggested by parents included improvements to home outdoor spaces, neighbourhood design and play spaces and community services. [ABSTRACT FROM AUTHOR]

This study describes the understanding, experiences and expectations of families living in rural and remote Australia regarding core concepts relating to disability service provision, including person‐centred practice (PCP), family‐centred practice (FCP), transdisciplinary practice (TDP), choice, control, inclusion, and equity. Thirteen parents or carers, each with a child with an intellectual disability aged between 6 and 16 years, living in rural and remote areas as described by the Australian Standard Geographical Classification – Remoteness Area (ASGC‐RA) and Modified Monash Model (MMM) – were recruited through distribution of flyers (hard copies or by email) to clinicians, schools, and advocacy agencies. Semi‐structured interviews were conducted with participants either in‐person or via telephone between July and October 2015. Data were analysed using thematic analysis. Participants reported that their understanding of many of the disability principles (PCP, FCP, choice, control, inclusion, and equity) was different from providers, and that many providers struggled to understand families, and therefore they did not share meaning of the principles of best practice disability supports. Families did not identify transdisciplinary practice as a core issue or tenet of effective service delivery. Families also reported experiences of missing out on services, feeling a sense of isolation in their communities, struggling to access skilled therapists, and difficulty finding supports and goals that were relevant to their child. The quality of supports that these families accessed was often below the standard that they expected. They did not expect that support standards will change in rural and remote Australia, so many have very low expectations of the National Disability Insurance Scheme (NDIS) in the future. Although more data will need to be collected as the NDIS and its markets mature, these data show that many rural and remote participants and their supporters have a variety of concerns about how they will access quality allied health services through the Scheme. [ABSTRACT FROM AUTHOR]

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

Gambling is recognized as a significant public health problem. However, there is little research exploring community attitudes towards gambling and the development of advocacy initiatives. Engaging adults and young people in advocacy efforts is recognized as being beneficial to the successful implementation of harm prevention and reduction strategies. This study explored the attitudes of young people and their parents towards the alignment of gambling with sport, and the strategies they perceive could be used to prevent and reduce gambling related harm. Using a Constructivist Grounded Theory approach, 30 family groups from Melbourne, Australia participated in semi-structured interviews. Parents and young people were asked about gambling and its promotion, alignment with sporting codes, the potential impact on young people and strategies that may prevent or reduce gambling harm. Thematic analysis was undertaken to interpret the data. The sample comprised 29 parents, one grandparent and 48 young people. Themes emerging from the data related to the use of imagery and appeal strategies in advertisements, the normalization of betting in advertisements and the alignment of betting with sport. Parents and young people also identified a number of potential gambling harm prevention and reduction initiatives. Parents and young people were able to describe a range of strategies used by gambling companies to promote their products, understand the potential impact of these strategies, and recommend strategies to reduce harm. Given this level of understanding there is clearly an opportunity to engage young people and stakeholders in advocacy initiatives aimed at reducing and preventing gambling harm. [ABSTRACT FROM AUTHOR]

Parenting support needs of patients diagnosed with incurable end-stage cancer (IESC) with young families are not addressed as part of routine hospital health care. Their support needs and experiences of hospital-based parenting support are largely unknown. The study aims to explore hospital-based parenting support delivery from patient and co-parent perspectives in context to their parenting experience and support needs. Exploratory, prospective, cross-sectional qualitative design. Semi-structured in-depth interviews with eight adult patients with IESC and four co-parents purposively recruited from a tertiary hospital in Melbourne, Australia. Findings were thematically analyzed. Parents desire support with challenging multidimensional parenting issues. Organization, health professionals (HP), and parental-based factors hinder and facilitate optimal service provision. Responsibility rests with HP to initiate parenting support. Interdisciplinary family-focused support offered throughout IESC health-care journey is key. Patient-centered family-focused support is warranted. Surmountable challenges lie with management and HPs to address barriers affecting optimal service delivery. [ABSTRACT FROM AUTHOR]