Sharon Goldfeld

Investigating the Validity of the Australian Early Development Index

This article aims to contribute to the ongoing evaluation of the Australian Early Development Index (AEDI) by investigating its construct and concurrent validity with a subsample of 642 children aged 4 to 5 years drawn from the Longitudinal Study of Australian Children (LSAC). Construct validity was examined by considering the theoretical consistency of the network of correlations between the AEDI subconstructs and the independently reported multimethod measures of early learning skills and development collected contemporaneously by the LSAC. Concurrent validity was examined by assessing the extent to which children who were “developmentally vulnerable” on the AEDI domains corresponded with the LSAC outcome indices classification of children as “developmentally at risk.” Moderate to large correlations were observed between each of the AEDI domains and subconstructs when compared to analogous teacher-rated LSAC measures, with lower levels of association observed for parent-rated LSAC measures. Concurrent validity was explored; however, with no criterion measure with which to assess the AEDI, findings are inconclusive prior to predictive validity assessment. Future waves of the LSAC will collect information on the childrens abilities at school and developmental outcomes, enabling further interpretation of these concurrent and construct validity findings by triangulation and predictive validity analyses.

Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: Let's Learn Language cluster randomised controlled trial

Objective To determine the benefits of a low intensity parent-toddler language promotion programme delivered to toddlers identified as slow to talk on screening in universal services. Design Cluster randomised trial nested in a population based survey. Setting Three local government areas in Melbourne, Australia. Participants Parents attending 12 month well child checks over a six month period completed a baseline questionnaire. At 18 months, children at or below the 20th centile on an expressive vocabulary checklist entered the trial. Intervention Maternal and child health centres (clusters) were randomly allocated to intervention (modified “You Make the Difference” programme over six weekly sessions) or control (“usual care”) arms. Main outcome measures The primary outcome was expressive language (Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years, Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw score at 2 and 3 years. Results 1217 parents completed the baseline survey; 1138 (93.5%) completed the 18 month checklist, when 301 (26.4%) children had vocabulary scores at or below the 20th centile and were randomised (158 intervention, 143 control). 115 (73%) intervention parents attended at least one session (mean 4.5 sessions), and most reported high satisfaction with the programme. Interim outcomes at age 2 years were similar in the two groups. Similarly, at age 3 years, adjusted mean differences (intervention−control) were −2.4 (95% confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to 3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6 to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2; P=0. 92) for internalising behaviour problems. Conclusion This community based programme targeting slow to talk toddlers was feasible and acceptable, but little evidence was found that it improved language or behaviour either immediately or at age 3 years. Trial registration Current Controlled Trials ISRCTN20953675.

Parents, infants and health care: Utilization of health services in the first 12 months of life

Objective:  To describe patterns of health‐service use in the first 12 months of life.

Jurisdictional, socioeconomic and gender inequalities in child health and development: analysis of a national census of 5-year-olds in Australia

Objectives Early child development may have important consequences for inequalities in health and well-being. This paper explores population level patterns of child development across Australian jurisdictions, considering socioeconomic and demographic characteristics. Design Census of child development across Australia. Setting and participants Teachers complete a developmental checklist, the Australian Early Development Index (AEDI), for all children in their first year of full-time schooling. Between May and July 2009, the AEDI was collected by 14 628 teachers in primary schools (government and non-government) across Australia, providing information on 261 147 children (approximately 97.5% of the estimated 5-year-old population). Outcome measures Level of developmental vulnerability in Australian children for five developmental domains: physical well-being, social competence, emotional maturity, language and cognitive skills and communication skills and general knowledge. Results The results show demographic and socioeconomic inequalities in child development as well as within and between jurisdiction inequalities. The magnitude of the overall level of inequality in child development and the impact of covariates varies considerably both between and within jurisdiction by sex. For example, the difference in overall developmental vulnerability between the best-performing and worst-performing jurisdiction is 12.5% for males and 7.1% for females. Levels of absolute social inequality within jurisdictions range from 8.2% for females to 12.7% for males. Conclusions The different mix of universal and targeted services provided within jurisdictions from pregnancy to age 5 may contribute to inequality across the country. These results illustrate the potential utility of a developmental census to shed light on the impact of differences in universal and targeted services to support child development by school entry.

Data Resource Profile: The Australian Early Development Index (AEDI)

Every 3 years, the Australian Government conducts a developmental census across the entire population of children in their first year of full-time schooling (median age 5 years). The first developmental census was conducted in 2009, including 261,147 children, and in 2012 data were collected on 289,973 children-representing 97.5% and 96.5% of the estimated eligible population, respectively. The questionnaire is completed by teachers on the basis of at least 1 months knowledge of the child, including aspects of physical, social, emotional, language and cognitive development, as well as data on special needs. Teachers are also asked to include details of the childs care arrangements and attendance in early education programmes in the years preceding school. Demographic and geographical data are recorded at the individual and area levels.

Prevalence and correlates of special health care needs in a population cohort of Australian children at school entry.

Objective: Children with special health care needs are an important population for educational and health service providers. Accurate information about the prevalence and characteristics of these children and their families is needed to inform the planning and development of systems of care, yet data in Australia are currently lacking. Methods: This study utilizes population-level data from the Australian Early Development Index, a teacher-rated checklist, to provide estimates of the prevalence and developmental and demographic characteristics of Australian children with special health care needs on entrance to school. Results: Four percent of children were reported with established special health care needs, and a further 18% were identified by teachers as “of concern.” These children showed higher rates of vulnerability across all domains of development. Although children with established special health care needs were represented across demographic profiles, proportions were greater among boys, those from lower socioeconomic status communities, and Indigenous and older children. In contrast, those living in more remote settings were as likely to be identified as “of concern” as their peers but were less likely to have established special health care needs. Conclusions: These findings have important implications for service provision and policy development. There are substantial opportunities to reorient schooling and early childhood systems to better detect and accommodate the needs of these children.

Decreasing trends in overweight and obesity among an Australian population of preschool children

Background:After several decades of increasing prevalence, recent evidence suggests a levelling of obesity rates in some groups, although little is known about trends in children under 5 years of age.Aim:To investigate the prevalence, trends and sociodemographic correlates of overweight and obesity in Australian preschool children between 1999 and 2007.Methods:Child anthropometric and demographic data were extracted from records of routine maternal and child health consultations for children aged 2 and 3.5 years in the Australian state of Victoria. Data were analysed for prevalence of overweight and obesity (according to International Obesity Task Force definitions), trends in prevalence from 1999 to 2007 and sociodemographic correlates of prevalence and trends.Results:Complete data were available for 129 266 2-year-old children and 96 164 3.5-year-old children from 41 local government areas across Victoria. Combined prevalence of overweight and obesity decreased significantly between 1999 and 2007 in 3.5-year-old children (by 3.1% points from 18.5 to 15.4%) and in 2-year-old children (1.1% point decrease from 13.5 to 12.4%). There was no accompanying increase in rates of underweight. Decreases were more pronounced in areas of lower socioeconomic status (SES). Prevalence of both overweight and obesity was consistently higher across time in the older group of children, in the lowest quartile of SES and among girls.Conclusions:Prevalence of overweight and obesity in preschool children in Victoria has decreased significantly between 1999 and 2007, whereas socioeconomic disparities have narrowed. Further research is needed to understand the reasons for the decreasing prevalence, and to better evaluate existing and emerging health promotion initiatives. Such evidence will be important to build on the findings of this study and to transfer lessons learnt to other population groups.

Population monitoring of language and cognitive development in Australia: The Australian Early Development Index

The Australian Early Development Index (AEDI) is a population measure of child development. The AEDI measures Language and Cognitive Development, Social Competence, Emotional Maturity, Physical Health and Wellbeing, and Communication Skills and General Knowledge. In Australia these data are collected by teachers for children in their first full time year of schooling. The aim of this paper is to aid peoples understanding and interpretation of population measures such as the AEDI. With a greater awareness of the merits and complexities of population data clinicians and allied health professionals can play a vital role in aiding communities and policy makers to interpret and act upon the data in an intelligent way. This paper is primarily descriptive providing background information on the development and use of the instrument utilizing one of the 5 developmental domains (Language and Cognitive Development) as an example. The results show a complex relationship between children residing in differing socio-economic regions, children with English as their primary or secondary language and children who are able or not able to effectively communicate in English.

The Process and Policy Challenges of Adapting and Implementing the Early Development Instrument in Australia.

Research Findings: Australian state and federal governments have increasingly recognized early childhood as a critical period for investing in interventions. At the same time, a number of organizational, structural, and environmental responses have been put in place to build the capacity of communities to better support children and their families. It was in this policy environment of increasing investment in community-level interventions to promote outcomes for children that the need emerged in Australia for a population measure of early childhood development. This article outlines some of the process and policy challenges associated with the introduction and adaptation of a population measure of early child development—the Early Development Instrument (EDI)—by Australian communities, which culminated in its adoption as a national measure of early childhood development in 2008. It highlights the need to develop both a strategic and psychometric approach to successfully implement any measure that requires community-wide participation. Practice or Policy: There were particular challenges to embedding the AEDI, and therefore data about early childhood developmental outcomes, within policy processes. These are discussed in terms of the adaptation and validation process in Australia, the development of novel methods of data collection for national implementation, the benefits of cross-national comparisons, and the policy impact and environment that has been necessary for longer term sustainability.

Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia

Asian infants born in Australia are three times more likely to develop nut allergy than non‐Asian infants, and rates of challenge‐proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole‐of‐state prevalence distribution of parent‐reported nut allergy in 5‐year‐old children entering school.