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Objectives: Childhood disturbances in social, emotional, language, motor and cognitive functioning, and schizotypy have each been implicated as precursors of schizophrenia‐spectrum disorders. We investigated whether relationships between early childhood developmental vulnerabilities and childhood schizotypy are mediated by educational underachievement in middle childhood. Methods: Participants were members of a large Australian (n = 19,216) population cohort followed longitudinally. Path analyses were used to model relationships between developmental vulnerabilities at age ~5 years, educational underachievement from ages ~8 to 10 years and three distinct profiles of schizotypy at age ~11 years (true, introverted and affective schizotypy). Results: Early childhood developmental vulnerabilities on five broad domains (related to physical, emotional, social, cognitive and communication development) were associated with schizotypy profiles in middle childhood. Educational underachievement in middle childhood was associated with all schizotypy profiles, but most strongly with the true schizotypy profile (OR = 3.92, 95% CI = 3.12, 4.91). The relationships between schizotypy profiles and early childhood developmental vulnerabilities in 'language and cognitive skills (school‐based)' and 'communication skills and general knowledge' domains were fully mediated by educational underachievement in middle childhood, and the relationships with early childhood 'physical health and well‐being' and 'emotional maturity' domains were partially mediated. Conclusion: Developmental continuity from early childhood developmental vulnerabilities to schizotypy in middle childhood is mediated by educational underachievement in middle childhood. While some domains of early developmental functioning showed differential relationships with distinct schizotypy profiles, these findings support a developmental pathway to schizotypy in which cognitive vulnerability operates from early childhood through to middle childhood. [ABSTRACT FROM AUTHOR]

Maltreated children are vulnerable to adverse mental health outcomes. Information about how children's mental health needs vary according to different levels of child protection contact (potentially culminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10 years and self-reported mental health difficulties at age 11 years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placed in OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placement and 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment. [ABSTRACT FROM AUTHOR]

Objectives: The detection of young people at high risk for psychotic disorders has been somewhat narrowly focused on overt symptom‐based markers that reflect mild reality distortion (e.g., psychotic‐like experiences), or prodromal syndromes that are proximal to psychosis onset. The concept of schizotypy represents a broader framework for investigating risk for schizophrenia (and other disorders) in childhood, before the onset of prodromal or overt symptoms. We sought to detect profiles of risk for psychosis (schizotypy) in a general population sample of 22,137 Australian children aged 11–12 years, and to determine early life risk factors associated with these profiles from data available in linked records (registers). Methods: Fifty‐nine self‐reported items were used as indicators of schizotypy across six broad domains; z‐scores for each domain were subjected to latent profile analyses (LPA). A series of multinomial logistic regressions was used to examine the association between resulting profile (class) membership and several childhood and parental risk factors, and the proportion of children with mental disorders among each schizotypy profile was examined. Results: The LPA revealed three person‐centred profiles referred to as True Schizotypy (n = 1,323; 6.0%), Introverted Schizotypy (n = 4,473; 20.2%), and Affective Schizotypy (n = 4,261; 19.2%), as well as a group of children showing no risk (n = 12,080; 54.6%). Prior exposure to perinatal and familial adversities including childhood maltreatment, as well as poor early childhood development and academic functioning, was variously associated with all risk groups. There was a higher proportion of childhood mental disorder diagnoses among children in the True Schizotypy group, relative to other profiles. Conclusion: Subtle differences in the pattern of exposures and antecedents among schizophrenia liability profiles in childhood may reflect distinct pathogenic pathways to psychotic or other mental illness. Practitioner points: Children aged 11–12 years report characteristics of schizotypy which can be classified into three distinct profiles that may represent different pathological processes towards later mental ill‐health.Early life exposure to perinatal and familial adversities including childhood maltreatment, early childhood developmental vulnerability, and poor academic functioning predict membership in all three childhood schizotypy profiles.Latent liability for schizophrenia (and potentially other mental disorders) may be represented by different profiles of functioning observable in childhood. [ABSTRACT FROM AUTHOR]

Children with disabilities are known to have high rates of contact with child protection services. However, little is known about child protection contacts for a broader group of children with special healthcare needs (SHCN; i.e., special needs or other impairments of concern that affect learning). This study examined the characteristics of contact with child protection services (prior to the age of 6 years) for children with SHCN identified at school entry using the 2009 Australian Early Development Census, using administrative data from more than 65,000 children in the New South Wales Child Development Study. Child protection contacts prior to age 6 years were more prevalent among children with SHCN compared with those without; in particular, children with SHCN had higher odds of a history of exposure to neglect and physical abuse, and higher odds of being placed in out‐of‐home care, compared with their typically developing peers. Understanding the characteristics of child protection contacts among children with SHCN, with consideration of factors that may influence their patterns of contact with these and other human services agencies, will inform the development of appropriate social policy initiatives to fulfil Australia's obligations under the United Nations Convention on the Rights of the Child. [ABSTRACT FROM AUTHOR]

Objectives: Childhood psychotic‐like experiences (PLEs) increase risk for concurrent and future psychiatric disorders but are common in the population. Strategies are needed to identify vulnerable individuals who may benefit from monitoring or targeted intervention. This study aimed to delineate profiles of childhood PLEs that might be differentially associated with other psychopathologies, and multiple psychopathology. Design: Cross‐sectional, online self‐report survey. Methods: Participants were 27,000 Australian children from a population cohort (13,416 girls; mean age 11.91 years) who completed an online self‐report questionnaire assessing PLEs (hallucinations and delusions) and Emotional, Peer Relationship, Conduct, and Hyperactivity–Inattention psychopathology. Latent class analysis differentiated classes of children showing different patterns of PLE responses, and multinomial logistic regression determined the association between the PLE classes and the various psychopathologies, adjusted for demographic covariates and the other psychopathologies. Results: Five latent profiles of PLE responses were characterized as follows: None (27.4% of children), Minor (29.7%), Moderate (11.8%), Hallucinatory (21.0%), and Strong (10.2%). These classes showed distinct associations with other psychopathologies (odds ratios between 1.27 and 4.58), and dose–response relationships indicated increasing likelihood of multiple psychopathology for the Hallucinatory and Strong classes (odds ratio = 21.87 for ≥3 psychopathologies in the Strong class). Conclusions: Tailored interventions that address the particular needs of these different classes of individuals may be warranted. Practitioner points: Children aged 11–12 years who report psychotic‐like experiences (PLEs) can be classified into five different PLE profiles based on self‐reported questionnaire responses, which may reflect different pathological processes.These PLE profiles show different patterns and magnitudes of increased risk for other types of psychopathology, and multiple psychopathology, suggesting that they present different treatment needs.Cross‐sectional investigation of the associations between PLE profiles and other psychopathologies limits any conclusions as to the causal direction of these relationships.Multi‐informant reports of psychopathology were unavailable. [ABSTRACT FROM AUTHOR]

Background: The intergenerational risk for mental illness is well established within diagnostic categories, but the risk is unlikely to respect diagnostic boundaries and may be reflected more broadly in early life vulnerabilities. We aimed to establish patterns of association between externalising and internalising vulnerabilities in early childhood and parental mental disorder across the full spectrum of diagnoses. Methods: A cohort of Australian children (n = 69 116) entering the first year of school in 2009 were assessed using the Australian Early Development Census, providing measures of externalising and internalising vulnerability. Parental psychiatric diagnostic status was determined utilising record-linkage to administrative health datasets. Results: Parental mental illness, across diagnostic categories, was associated with all child externalising and internalising domains of vulnerability. There was little evidence to support interaction by parental or offspring sex. Conclusions: These findings have important implications for informing early identification and intervention strategies in high-risk offspring and for research into the causes of mental illness. There may be benefits to focusing less on diagnostic categories in both cases. [ABSTRACT FROM AUTHOR]