BACKGROUND An increase in the prevalence of neurodevelopmental conditions worldwide, alongside resource constraints within clinical services, has led to increased interest in health information technologies, such as apps and digital resources. Digital tools are often viewed as a solution to bridge this divide and to increase supports for families. There is, however, a paucity of research that has evaluated digital health tools, their potential benefits for child neurodevelopment and associated concerns (eg, mental health, well-being), and their benefit for families. OBJECTIVE This study conducted the first review of existing mobile apps and digital resources targeted at supporting the needs of children with developmental concerns or neurodevelopmental conditions. METHODS We identified 3435 separate resources, of which 112 (43 apps and 69 digital resources) met the criteria. These resources were categorized according to their purpose or target and were then reviewed based on their engagement, information quality, and evidence base using the Adapted Mobile App Rating Scale. RESULTS The most common condition of concern targeted by apps and digital resources was autism (19/112, 17% resources), with retrieved resources focusing on supporting challenging behaviors, promoting speech, language, and social development, and providing options for alternative and assistive communication. Other common areas of concern targeted by apps and digital resources included language and communication (16/112, 14.3%) and attention-deficit/hyperactivity disorder (11/112, 9.8%). Results showed that reviewed resources were engaging, with high levels of accessibility and functionality. Resources had various functions, including developmental or behavioral tasks targeted at children, assistive communication support, scheduling support, journaling, and advice, activities, and strategies for parents. The information quality of resources, such as credibility of source and evidence base was, however, mostly low. Apps and digital resources with good credibility and an existing evidence base were largely developed in partnership with research, health, or government institutions, and were rated significantly higher on overall quality compared with apps and digital resources not developed in partnership with such institutions (apps; t41=–4.35, P<.001; digital resources; t67=–4.95, P<.001). CONCLUSIONS The lack of evidence base across resources means that it is extremely difficult to provide recommendations to families with respect to apps or digital resources that may support their needs. Frameworks for the development of new tools are discussed, highlighting the novel approaches required to demonstrate the efficacy of tools for improving outcomes for children and families. Such a framework requires collaboration with multiple stakeholders (software developers, researchers, regulatory bodies, clinicians, children, and families) and engagement across multiple levels of expertise (app development, implementation, and dissemination within services, policy, and clinical regulations), to harness the potential of digital health for improving outcomes and promoting support in child neurodevelopment, which at this juncture remains largely underdeveloped.
Kelsie Boulton, Makana Hilton, Emilia Sutton et al.
This article reports on a study that provides insights into the challenges faced by practitioners in the Northern Territory (NT) who support families in enhancing child safety and well-being, particularly for children at risk of or exposed to domestic or family violence. Despite increased funding for programs aimed at improving children's safety and well-being, reports and substantiations of child maltreatment in the NT continue to escalate. Interviews with twelve participants from various organizations involved in child protection services, family support services, and residential care shed light on the existing gaps in support services, including limited resources for families escaping domestic violence and inadequate assistance for children transitioning from out-of-home care. The findings emphasize the need for early intervention services targeted at families displaying risk factors for child maltreatment. Additionally, community consultation is crucial for the design and implementation of support programs that align with the unique needs of communities, including the necessity of maintaining connections to community, culture, and family to address concerns related to meeting basic needs. The study calls for a comprehensive approach that integrates community input, cultural safety, and tailored support programs to bridge these gaps and facilitate lasting positive changes. By addressing these challenges, there is a potential to mitigate child maltreatment and improve the well-being of children and families in the NT, contributing to the overall welfare of the community.
Ashlee Reynolds, Steven Roche, Timothy M. Piatkowski
Purpose: Difficult temperament coupled with other risk factors may lead to mental health problems in childhood and have long-lasting effects in adolescence and adulthood. This study aimed to investigate the prevalence of parental perception of difficult temperament in toddlers and identify significant factors associated with individual and family-level sociodemographic risk factors. Patients and Methods: The prevalence of parental perception of difficult temperament was derived from items in the 18-month follow-up questionnaire within the Watch Me Grow (WMG) longitudinal birth cohort study in a multicultural and socioeconomically disadvantaged community in Sydney, Australia. Data was available for 500 children and their parents. Descriptive analysis was used to calculate the participant characteristics and the prevalence of parental perception of difficult temperament, whereas multivariable logistic regression analysis was used to assess significant risk factors associated with a difficult temperament. Results: Parental perception of difficult temperament in the cohort was 7.3% (n = 492). Findings of the multivariable logistic regression showed that screen time >2 hours a day (AOR 2.43, 95% CI: 1.2, 4.9), child not being read to (AOR 3.92, 95% CI: 1.8, 8.5), and family history of mental health problems (AOR 2.69, 95% CI: 1.1, 6.5) significantly increased the odds of having a difficult temperament. Conclusion: Toddlers with difficult temperament were less likely to have received stimulatory experiences, and their families were more likely to be under greater stress. The findings emphasize the importance of parental support and anticipatory guidance in promoting nurturing care to facilitate child health and development, particularly in disadvantaged communities.
A'ishah Bhadelia, Karlen R. Barr, James Rufus John et al.
Early childhood education is a sector often mis-represented in the media and public domain, depicting a sector beleaguered by low salaries, lack of professional recognition and inadequate working conditions. Missing from this depiction is the fullness of the everyday teaching and learning experiences of early childhood educators, and subsequent joy experienced in working with young children and families and the significant contribution of this emotion to educator practice and sense of wellbeing. Using an online survey, educators were invited to share their perspectives of factors that are contributing to the crisis in the field, their daily encounters with children and the moments, both big and small, that shaped and guided their pedagogy. Findings suggested that while the concept of joy was embraced and validated by educators, it was also elusive and hard to define. Suggestions for validating the place of joy as central in early childhood education conclude the paper.
Portfolios are widely used in New Zealand for documenting children’s learning; there is now an increasing move to online ePortfolios. This article presents findings from a doctoral study which investigated the impact of the introduction of ePortfolios in an early childhood education setting where traditional paper-based portfolios were previously used as the formative assessment tool for children’s learning. The findings demonstrate that a significant benefit of the ePortfolio system used in this study was the ways in which they could support children to revisit their learning and become involved in their own formative assessment. This is described as recalling, reconnecting and restarting. Through participating in these processes, children become active contributors to their own learning journeys which is a significant factor of formative assessment.
The community (or neighbourhood) is seen as a potential point of intervention for improving early childhood development outcomes through place-based approaches targeting all children. Yet there are insufficient robust data to guide policy and practice. Developing community factors for early childhood development is one way to facilitate more informed, evidence-based community action. This paper discusses the methodological learnings from the Kids in Communities Study, an Australian investigation into community-level factors important for early childhood development, including some of the challenges and innovations associated with the measurement and development of indicators. It highlights the importance of not only developing quantitative community indicators, but also in capturing qualitative data that emerge from communities. In an environment where the implementation of place-based approaches has outpaced the evidence, there is an urgent need for rigorous evidence that can identify community factors (and hence potential actions) that might influence early childhood development.
Sharon R Goldfeld, Karen Villanueva, Robert Tanton et al.
Literacy skills are essential for success in today’s society. However, classrooms often have suboptimal acoustic conditions for learning. The goal of this review was to synthesize research assessing the effect of different classroom acoustic conditions on children’s literacy. A comprehensive search of four online databases was conducted in August 2021. The search term was classroom AND (noise OR reverberation OR acoustics) AND (reading OR spelling OR writing OR literacy). Eighteen papers were deemed relevant for the review plus an additional seven from their references. The types of acoustic conditions that have been assessed, the types of measures used to assess literacy, and the effect of the acoustic conditions on children’s reading, writing, and spelling outcomes are discussed. Suggestions for the classroom acoustic conditions needed to ensure appropriate literacy development and areas for future research are also considered.
The rights of Aboriginal and Torres Strait Islander families, communities and organisations to participate in all significant child protection decision-making in New South Wales (NSW) are legislatively recognised through sections 11, 12 and 13 of the Children and Young Persons (Care and Protection) Act 1998 (the ‘Care Act’). These rights sit alongside and are augmented by an international legal framework which recognises the centrality of the family in a child’s life and the importance of cultural self-determination in child-rearing as a fundamental human right. Despite this recognition — in the NSW statute and within international human rights law — there are many anecdotal accounts and a building body of evidence of the routine breach of Aboriginal families’, communities’ and organisations’ rights to be heard and to contribute to child protection decision-making. Indeed, it is widely argued and perceived that Australian child protection systems remain embedded within a deeply colonial complex of institutions and processes — all of which undermine meaningful participation of Aboriginal families, communities and organisations in child protection decision-making
Terri Libesman, Wendy Hermeston, Eloise Chandler et al.
AIM: To investigate if there are inequities in quality and safety outcomes for children with intellectual disability admitted to two tertiary paediatric hospitals. METHOD: A cross-sectional study of 1367 admissions for 1018 randomly selected patients admitted for more than 23 hours to one of two tertiary children's hospitals in Sydney, Australia (1st January-31st December 2017). Electronic medical records were manually interrogated to identify children with intellectual disability (including developmental delay). Data extracted included patient demographics, length of stay, number of admissions, and reported clinical incidents. RESULTS: In total, 12.3% (n=125) of children admitted during the study period had intellectual disability, which represented 13.9% (n=190) of admissions. Sex and age at admission in children with and without intellectual disability were similar: 83 (43.7%) vs 507 (43.1%) females and 107 (56.3%) vs 670 (56.9%) males, p=0.875; median age 3 years (0-18y) vs 4 years (0-18y), p=0.122. Children with intellectual disability had significantly greater median length of stay (100.5h vs 79h, p<0.001) and cost of admission (A$11 596.38 vs A$8497.96) than their peers (p=0.001). Children with intellectual disability had more admissions with at least one incident compared to children without intellectual disability (14.7% vs 9.7%); this was not statistically significant (p=0.06). INTERPRETATION: Children with intellectual disability experience inequitable quality and safety outcomes in hospital. Engaging children and families in clinical incident reporting may enhance understanding of safety risks for children with intellectual disability in hospital.
Laurel Mimmo, Reema Harrison, Joanne Travaglia et al.
While children’s experiences of online risks and harm is a growing area of research in New Zealand, public discussion on the matter has largely been informed by mainstream media’s fixation on the dangers of technology. At best, debate on risks online has relied on overseas evidence. However, insights reflecting the New Zealand context and based on representative data are still needed to guide policy discussion, create awareness, and inform the implementation of prevention and support programmes for children. This research report presents findings from a quantitative study regarding different aspects related to risks and online safety. It looks at the online experiences that children find bothersome and upsetting and explores the hurtful behaviours they encounter or engage in, both online and in person. Evidence regarding exposure to different types of potentially harmful online content is also presented. Another relevant contribution is the insights related to excessive internet use.The findings presented in this report are based on data from 2,061 New Zealand children aged 9-17. We hope the findings will contribute to the development of policies, practices and services designed to support New Zealand children to safely take advantage of the opportunities available to them online.
