Do twins differ from single-born children on rates of behavioral difficulty in early childhood? A study of sibling relationship risk factors

The hypothesis that twinning raises risk for behavioral difficulties in childhood is persistent, yet there is limited and inconsistent empirical evidence. Simple mean comparison without control for confounders provides data on prevalence rates but cannot provide knowledge about risk or etiology. To assess the effect of twin relationship on behavior, comparison of patterns of association with single-born siblings may be informative. Analyses of data from an Australian sample of twins and single-born children (N = 305, mean age 4 years 9 months, and a follow-up 12 months later) were undertaken. The outcome measure was the Strengths and Difficulties Questionnaire. Predictor and control measures were obtained from parent report on the sibling/co-twin relationship behavior, family demographics, and obstetric history. We assessed difference between twins and single-born children in two respects: (a) mean behavioral difficulties, and (b) patterns of association between sibling relationship and behavioral difficulties, controlling for confounders. Results showed no differences in mean levels of behavioral difficulties between twins and single-born siblings identifying the importance of statistical control for family and obstetric adversity. Differences in patterns of association were found; for twin children, conflict in their co-twin relationship predicted externalizing behaviors, while for single-born children conflict predicted internalizing behaviors. The findings of mean differences between twin and single-born children in social background, but not in behavioral difficulties, underscore the necessity of statistical control to identify risk associated with twinning compared with risk associated with family and obstetric background factors.

“Do I really need a nap?”: The role of sleep science in informing sleep practices in early childhood education and care settings

A compelling body of studies identifies the importance of sleep for children’s learning, behavioral regulation, and health. These studies have primarily focused on nighttime sleep or on total sleep duration. The independent contribution of daytime sleep, or napping, in childhood is an emerging research focus. Daytime sleep is particularly pertinent to the context of early childhood education and care (ECEC) where, internationally, allocation of time for naps is commonplace through to the time of school entry. The biological value of napping varies with neurological maturity and with individual circumstance. Beyond the age of 3 years, when monophasic sleep patterns become typical, there is an increasing disjuncture between children’s normative sleep requirements and ECEC practice. At this time, research evidence consistently identifies an association between napping and decreased quality and duration of night sleep. We assess the implications of this evidence for educational practice and health policy. We identify the need to distinguish the functions of napping from those of rest, and assert the need for evidence-based guidelines on sleep–rest practices in ECEC settings to accommodate individual variation in sleep needs. Given both the evidence on the impact of children’s nighttime sleep on long-term trajectories of health and well-being and the high rates of child attendance in ECEC programs, we conclude that policy and practice regarding naptime have significant implications for child welfare and ongoing public health.

Assessing the value of mandatory sleep/rest periods in early childhood education and care

In Australia while "appropriate provision for sleep and rest" in early education and care settings is legislated there is no research base to define appropriate practice. This study provided the first, comprehensive documentation of sleep practices in early education and care and assessed their impacts on child health and well-being. The evidence supports development of practice guidelines to manage the complex individual and organisational factors associated with provisions for sleep and rest. The thesis contributes to significant international debate in sleep science regarding the benefits of promoting day-sleep during a period characterized by decline in biological propensity to nap.

Parent feeding interactions and practices during childhood cancer treatment: A qualitative investigation

In the general population it is evident that parent feeding practices can directly shape a child’s life long dietary intake. Young children undergoing childhood cancer treatment may experience feeding difficulties and limited food intake, due to the inherent side effects of their anti-cancer treatment. What is not clear is how these treatment side effects are influencing the parent–child feeding relationship during anti-cancer treatment. This retrospective qualitative study collected telephone based interview data from 38 parents of childhood cancer patients who had recently completed cancer treatment (child’s mean age: 6.98 years). Parents described a range of treatment side effects that impacted on their child’s ability to eat, often resulting in weight loss. Sixty-one percent of parents (n = 23) reported high levels of stress in regard to their child’s eating and weight loss during treatment. Parents reported stress, feelings of helplessness, and conflict and/or tension between parent and the child during feeding/eating interactions. Parents described using both positive and negative feeding practices, such as: pressuring their child to eat, threatening the insertion of a nasogastric feeding tube, encouraging the child to eat and providing home cooked meals in hospital. Results indicated that parent stress may lead to the use of coping strategies such as positive or negative feeding practices to entice their child to eat during cancer treatment. Future research is recommended to determine the implication of parent feeding practice on the long term diet quality and food preferences of childhood cancer survivors.

Executive functioning of 4 children with hyperphenylalaninemia from childhood to adolescence

Hyperphenylalaninemia is a variant of phenylketonuria, and debate remains as to what, if any, active management of this condition is required to preserve cognitive function and psychological well-being. This study is the first to examine longitudinally the executive function (EF) in adolescents with hyperphenylalaninemia. Two sibling pairs with mild hyperphenylalaninemia underwent neuropsychological examination in early childhood and again in adolescence using EF tests that were highly sensitive to phenylalanine exposure. By early adolescence, none of the 4 children demonstrated EF impairment. The children demonstrated a typical developmental trajectory of EF from childhood to adolescence, given phenylalanine exposure consistent with their condition.

Childhood atopic dermatitis : a cross-sectional study of relationships between child and parent factors, atopic dermatitis management, and disease severity

Background: Successful management of atopic dermatitis poses a significant and ongoing challenge to parents of affected children. Despite frequent reports of child behaviour problems and parenting difficulties, there is a paucity of literature examining relationships between child behaviour and parents' confidence and competence with treatment. Objectives: To examine relationships between child, parent, and family variables, parents' self-efficacy for managing atopic dermatitis, self-reported performance of management tasks, observed competence with providing treatment, and atopic dermatitis severity. Design: Cross-sectional study design. Participants A sample of 64 parent-child dyads was recruited from the dermatology clinic of a paediatric tertiary referral hospital in Brisbane, Australia. Methods: Parents completed self-report questionnaires examining child behaviour, parents' adjustment, parenting conflict, parents' relationship satisfaction, and parents' self-efficacy and self-reported performance of key management tasks. Severity of atopic dermatitis was assessed using the Scoring Atopic Dermatitis index. A routine home treatment session was observed, and parents' competence in carrying out the child's treatment assessed. Results: Pearson's and Spearman's correlations identified significant relationships (p< .05) between parents' self-efficacy and disease severity, child behaviour difficulties, parent depression and stress, parenting conflict, and relationship satisfaction. There were also significant relationships between each of these variables and parents' self-reported performance of management tasks. More profound child behaviour difficulties were associated with more severe atopic dermatitis and greater parent stress. Using multiple linear regressions, significant proportions of variation in parents' self-efficacy and self-reported task performance were explained by child behaviour difficulties and parents' formal education. Self-efficacy emerged as a likely mediator for relationships between both child behaviour and parents' education, and self-reported task performance. Direct observation of treatment sessions revealed strong relationships between parents' treatment competence and parents' self-efficacy, outcome expectations, and self-reported task performance. Less competent task performance was also associated with greater parent-reported child behaviour difficulties, parent depression and stress, parenting conflict, and relationship dissatisfaction. Conclusion: This study revealed the importance of child behaviour to parents' confidence and practices in the context of atopic dermatitis management. Children with more severe atopic dermatitis are at risk of presenting with challenging behaviour problems and their parents struggle to manage the condition successfully.

The impact of childhood malnutrition on schooling : evidence from Bangladesh

Summary This paper examines the impact of childhood malnutrition on schooling performance in rural Bangladesh. The results reveal that malnourished children are less likely to enrol in school on time and achieve an age-appropriate grade by 26 percentage points and 31 percentage points, respectively. Other important determinants of schooling outcomes include infrastructure and education level of parents. One major contribution of this paper is the control for the endogeneity of malnutrition status, which otherwise might lead to bias estimates.

“Heroic victims”: Discursive constructions of early childhood teacher professional identities

Significant changes to qualification requirements for staff working in early childhood contexts are occurring globally. A key reform in Australia is a call for teachers in prior to school early childhood contexts to be university-qualified. The “universal access” strategy (Department of Education, Employment of Workplace Relations [DEEWR], 2009a, 2009b; Rudd & Macklin, 2007b) requires four-year qualified early childhood teachers who are prepared to work in child care contexts. Yet studies in identify that cohorts of preservice teachers resist child care as a career option (see Ailwood & Boyd, 2006; Gibson, 2013a; Vadja, 2005a, 2005b). It is this point of tension that has prompted further inquiry into child care and work in child care, and forms the basis for this paper.

The ‘state of play’ in Australia: Early childhood educators and play-based learning

This article provides an overview of the Education Meets Play study that will investigate early childhood educators’ use of play-based learning, now mandatory under the National Quality Standard. By building on what can be gleaned about educators’ approaches to play-based learning prior to the implementation of the Early Years Learning Framework, the study will contribute to the evidence base concerning the implementation and effects of Australia’s early childhood education and care policy reform initiatives.

"Doing” social justice in early childhood: The potential of leadership

Early childhood education and care (ECEC) has long been connected with objectives related to social justice. ECEC in Australia has its roots in philanthropic and educational reform movements, and more recently with the National Early Childhood Reform Agenda, ECEC has once more been linked to the redressing inequality and disadvantage. Drawing on extant literature, including data from two previously reported Australian studies in which leadership emerged as having a transformational impact on service delivery, this paper examines the potential of early childhood leadership to generate ‘socially just’ educational communities. With reference to critical theory, we argue that critically informed, intentional and strategic organisational leadership can play a pivotal role in creating changed circumstances and opportunities for children and families.

Peripapillary choroidal thickness in childhood

Changes in the thickness of the invivo peripapillary choroid have been documented in a range of ocular conditions in adults; however, choroidal thickness in the peripapillary region of children has not been examined in detail. This study therefore aimed to investigate the thickness of the peripapillary choroid and the overlying retinal nerve fibre layer (RNFL) in a population of normal children with a range of refractive errors. Ninety-three children (37 myopes and 56 non-myopes) aged between 11 and 16 years, had measurements of peripapillary choroidal and RNFL thickness derived from enhanced depth imaging optical coherence tomography images (EDI-OCT, Heidelberg Spectralis). The average thickness was determined in a series of five 0.25 mm width concentric annuli (each divided into 8 equal sized 45° sectors) centred on the optic nerve head boundary, accounting for individual ocular magnification factors and the disc-fovea angle. Significant variations in peripapillary choroidal thickness were found to occur with both annulus location (p<0.001) and sector position (p<0.001) in this population of children. The innermost annulus (closest to the edge of the optic disc) exhibited the thinnest choroid (mean 77 ± 16 μm) and the outermost annulus, the thickest choroid (191 ± 52 μm). The choroid was thinnest inferior to the optic nerve head (139 ± 38 μm) and was thickest in the superior temporal sector (157 ± 40 μm). Significant differences in the distribution of choroidal thickness were also associated with myopia, with myopic children having significantly thinner choroids in the inner and outer annuli of the nasal and temporal sectors respectively (p<0.001). RNFL thickness also varied significantly with annulus location and sector (p<0.001), and showed differences in thickness distribution associated with refractive error. This study establishes the normal variations in the thickness of the peripapillary choroid with radial distance and azimuthal angle from the optic nerve head boundary. A significant thinning of the peripapillary choroid associated with myopia in childhood was also observed in both nasal and temporal regions. The changes in peripapillary RNFL and choroidal thickness associated with refractive error are consistent with a redistribution of these tissues occurring with myopic axial elongation in childhood.

Assessment of temperature effects on childhood pneumonia and diarrhoea

This thesis has identified the high risk areas of childhood pneumonia and diarrhoea in Queensland and quantified the effects of temperature on emergency department visits for childhood pneumonia and diarrhoea. It adds to the increasing evidence about the impacts of climate variability and change on children's health and may have significant implications for developing climate change adaptation strategies and paediatric care policies.