Susan Woolfenden

Family and parenting interventions for conduct disorder and delinquency: a meta-analysis of randomised controlled trials

Aims: To determine whether family and parenting interventions benefit children and adolescents with conduct disorder and delinquency. Methods: Meta-analysis of eight randomised controlled trials involving 749 children and adolescents (aged 10–17 years) with conduct disorder and/or delinquency. Criminality, academic performance, future employment, problem behaviour, family functioning, parental mental health, and peer relations were evaluated. Results: Family and parenting interventions significantly reduced the time spent by juvenile delinquents in institutions (weighted mean difference 51.34 days). There was also a significant reduction in the risk of a juvenile delinquent being rearrested (relative risk 0.66) and in their rate of subsequent arrests at 1–3 years (standardised mean difference −0.56). Conclusions: The evidence suggests that family and parenting interventions for juvenile delinquents and their families have beneficial effects on reducing time spent in institutions and their criminal activity. In addition to the obvious benefit to the participant and their family, this may result in a cost saving for society.

A systematic review of two outcomes in autism spectrum disorder - epilepsy and mortality

Aim  It has been reported that rates of epilepsy and mortality are higher among the population with autism spectrum disorder (ASD) than in the general population. The aim of this systematic review is to provide comprehensive evidence for clinicians, carers, and people with ASD regarding these outcomes.

Factors influencing breastfeeding rates in south-western Sydney.

Aim:  To explore the socio‐demographic factors and other maternal characteristics that influence breastfeeding initiation rates. In particular, this paper aims to (i) estimate the rate of breastfeeding by maternal socio‐demographic factors and other maternal characteristics at first well‐baby visit; and (ii) investigate the relationship between breastfeeding rates and these maternal factors.

Iron deficiency in children with global developmental delay and autism spectrum disorder

To investigate the prevalence of and risk factors for iron deficiency in children with global developmental delay and/or autism spectrum disorder (ASD).

A systematic review of the prevalence of parental concerns measured by the Parents’ Evaluation of Developmental Status (PEDS)indicating developmental risk

BackgroundParental concerns about their children’s development can be used as an indicator of developmental risk. We undertook a systematic review of the prevalence of parents’ concerns as an indicator of developmental risk, measured by the Parents’ Evaluation of Developmental Status (PEDS) and associated risk factors.MethodsElectronic databases, bibliographies and websites were searched and experts contacted. Studies were screened for eligibility and study characteristics were extracted independently by two authors. A summary estimate for prevalence was derived. Meta-regression examined the impact of study characteristics and quality. Meta-analysis was used to derive pooled estimates of the impact of biological and psychosocial risk factors on the odds of parental concerns indicating high developmental risk.ResultsThirty seven studies were identified with a total of 210,242 subjects. Overall 13.8% (95% CI 10.9 -16.8%) of parents had concerns indicating their child was at high developmental risk and 19.8% (95% CI 16.7-22.9%) had concerns indicating their child was at moderate developmental risk. Male gender, low birth weight, poor/fair child health rating, poor maternal mental health, lower socioeconomic status (SES), minority ethnicity, not being read to, a lack of access to health care and not having health insurance were significantly associated with parental concerns indicating a high developmental risk.ConclusionsThe prevalence of parental concerns measured with the PEDS indicating developmental risk is substantial. There is increased prevalence associated with biological and psychosocial adversity.Trial registrationPROSPERO Registration: CRD42012003215.

Autism in context 1: Classification, counting and causes

This review paper describes our current perspective of autism spectrum disorders (ASD), taking into account past, current and future classification systems and the evolving definitions of ASD. International prevalence rates from 1965 to 2012 are presented and key issues, including whether there is an epidemic of autism and what this means in terms of thinking about possible causes of autism, are discussed. Also discussed is the need for high quality national data collection in Australia and the evidence, and lack of evidence, for the many theoretical causes of ASD. The lack of robust classification of autism along with limited high quality evidence base about its prevalence and possible causes leaves ample space for future discoveries.

Barriers to immunization: Attitudes of general practitioners to varicella, the disease and its vaccine

Objectives:  To investigate the attitudes of general practitioners (GPs) to varicella disease and varicella vaccine.

Human rights and child health

Abstract:  Human rights are those basic standards without which people cannot live in dignity.

School-Based Education Programs for the Prevention of Child Sexual Abuse: A Cochrane Systematic Review and Meta-Analysis.

Objective: To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse (CSA). The programs deliver information about CSA and strategies to help children avoid it and encourage help seeking. Methods: Systematic review including meta-analysis of randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs. Results: Twenty-four studies with 5,802 participants were included. Child self-protective skills, odds ratio = 5.71, confidence interval = [1.98, 16.51]; factual, standardized mean difference (SMD) = 0.61 [0.45, 0.78]; and applied knowledge, SMD = 0.45 [0.24, 0.65], increased in the intervention group, and knowledge gains were retained at 6 months, SMD = 0.69 [0.51, 0.87]. There were no differences in anxiety or fear, SMD = −0.08 [0.22, 0.07], and findings regarding disclosure of abuse were inconclusive. Conclusion: Children’s self-protective skills and knowledge can be increased by participation in school-based sexual abuse prevention programs. However, it is unknown whether gains in skills and knowledge actually decrease the likelihood of CSA.

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.