Reliability of routinely collected hospital data for child maltreatment surveillance

Background: Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods: A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results: In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most ‘under-coded’ by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion: Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

Monitoring children's progress using child portfolios

Introduces a method to early childhood professionals of observing children as they are involved in everyday play episodes, record children's development and plan for this, while utilising the knowledge and input of the key players in the partnership, parents and teachers.

Book review : Kellett, M (2010) Rethinking children and research : attitudes in contemporary society

Rethinking Children and Research characterizes Mary Kellett’s vision as campaigner and sociologist actively working for and with children for many years. The book itself is not only visionary; it is informative, thought provoking and pragmatic. From a contemporary standpoint, the manuscript presents a detailed synopsis of the shifts in thinking about research with children and provides an appraisal of the theoretical movements that have driven a participatory research agenda. A strong theoretical approach of the combined lenses of sociologies of childhood and rights discourse is introduced early in the book. From the outset, the reader receives loud and clear, the key message of the book: that children in research should and can be included as competent members who lead research in the study of their everyday lives. The argument for a more mutual research approach is shaped throughout the book using research examples and practical suggestions on how this might be achieved. Overall, the reader is left feeling compelled to adopt such an approach.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

Background The relationship between positive parent-child interactions and optimal child development is well established. Families with a child with a disability may face additional challenges to establishing positive parent-child relationships. There are limited studies addressing the effectiveness of interventions which seek to address these issues with parents and young children with a disability. In particular, prior studies of music therapy with this group have been limited by small sample sizes and the use of measures of limited reliability and validity. Objective This study investigates the effectiveness of a short-term group music therapy intervention for parents who have a child with a disability and explores the factors associated with higher outcomes for participating families. Methods The participants were 201 mother-child dyads, where the child had a disability. Pre and post intervention parental questionnaires and clinician observation measures were taken on a range of parental wellbeing, parenting behaviours and child developmental factors. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Results Significant improvements pre to post were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence that parents were very satisfied with the program and that it brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. Conclusions This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas. Whilst several limitations are discussed, the study does address some of the gaps in the music therapy evidence base in this area.

Children of substance-using mothers : child health engagement and child protection outcomes

Aim: Maternal substance use has been associated with a range of child risk factors. The study investigated the relationship between engagement with child health services and child protection outcomes for children of substance using mothers. ----- ----- Methods: A sample of 119 children of mothers who disclosed opiate, amphetamine or methadone use during a maternity admission between 2000 and 2003, as included in a previous matched co-hort study1, were included in the current study. Statutory child protection agency and child health engagement information for the first two years of life, was obtained. The relationship between type of maternal substance use, child health engagement and child protection outcomes was examined. ----- ----- Results: Seventy two percent of study group infants were engaged with child health services during the first two years of life. Chi square analysis showed no significant relationship between child health engagement and child protection reports. Child health engagement was associated with decreased substantiated child protection notifications for children of methadone using mothers, but not for children of illicit substance users. ----- ----- Conclusions: Almost a quarter of identified children of substance using mothers are not accessing standard child health services in their first two years of life. This study provides support for increased attention to the provision of child health services for children of methadone using mothers. Further research into effective intervention strategies for children of illicit substance using mothers is indicated.

Employers and child workers : an institutional approach

This article explores employers' perspectives on the introduction of child employment legislation in Australia through the lens of the three pillars—regulative, normative and cultural-cognitive—of institutional theory. The study extends the traditional industrial relations (IR) focus on regulation to examine how human resource (HR) practices around child employment become legitimised, normalised and socially supported.

Educational policy for citizenship in the early years in Australia

This paper explores how young children are constructed in educational policy for citizenship in Australia, investigating tensions between early childhood educational discourses that construct young children as active citizens and the broader discourses of citizenship in Australian educational policy. There is a widespread discourse within early childhood education that regards young children as citizens and democratic participants in their own lives. This view is a reflection of the oft cited Article 12 in the UN Convention on the Rights of the Child (UNCRC 1989). However, educational policy and curriculum for citizenship in Australia, by and large, adheres to age and stage understandings of children, implicitly deeming young children unable to conceptualise abstract ideas of what it means to ‘be a good citizen’. This paper is located in the borders and intersections between discourses of early childhood education, young children as active participants in their own lives and what it means to be an active citizen in Australia. We are concerned with the interweaving of these ideas and how they are played out in educational policy making. This is an important perspective to take for governing and policy making are exercises in harnessing existing ideas and discourses, thereby rendering strategies and tactics for managing populations thinkable and sayable (Rose 1999). The ‘views from the margins’ (Burman 2008, p. 7) can provide alternative perspectives on policymaking, illuminating discursive tactics and strategies.

Everything is child abuse

In 2008, the Australian federal Senate held an Inquiry into the Sexualisation of Children in the Contemporary Media Environment. I made a submission to this Inquiry, noting that in public debate about this topic a number of quite distinct issues, with distinct aetiologies, were collapsed together. These included: child pornography; children being targeted by any form of marketing; young people becoming sexually active; sexual abuse of children; raunch culture; protecting children from any sexualised material in the media; and body image disorders. I suggested that commentators had collapsed these issues together because the image of the helpless child is a powerful one for critics to challenge undesirable aspects of contemporary culture. The result of many different ideological viewpoints all using the same argument - that the forms of culture they didn't like were damaging children - gives the impression that there is no element of culture today that isn't (somebody claims) causing harm to children: everything is child abuse. The danger of such discourses is that they draw attention away from the real harm that is being caused to children by sexual and other forms of maltreatment - which overwhelmingly occur within families, and for reasons ignored in these debates.

Children’s food and activity patterns following a six-month child weight management program

Objective To describe the impact of a parent-led, family focused child weight management program on the food intake and activity patterns of pre-pubertal children. Methods n assessor-blinded, randomized controlled trial involving 111 (64% female) overweight, pre-pubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Study outcomes were assessed at baseline, 6 months, and 12 months. This paper presents data on food intake assessed via a validated 54-item parent completed dietary questionnaire and activity behaviours assessed via a parent-report 20-item activity questionnaire. Results Intake of energy-dense nutrient poor foods was lower in both intervention groups at 6 months (mean difference, P+DA -1.5 serves [CI -2.0;-1.0]; P -1.0 serves [-2.0;-0.5]) and 12 months (mean difference P+DA -1.0 serves [CI -2.0;-0.5]; P -1.0 serves [-1.5; 0.0]) compared to baseline. Intake of vegetables, fruit, breads and cereals, meat and alternatives and dairy foods remained unchanged. Regardless of study group there were significant reductions over time in the reported time spent engaged in small screen activities and an increase in the time reported spent in active play. Conclusion Child weight management intervention that promotes food intake in line with national dietary guidelines achieves a reduction in children’s intake of energy dense, nutrient poor foods. This was achieved without compromising intake of nutrient-rich food and changes in were maintained even once the intervention ceased.

Why a child needs a critical eye, and why the art classroom is central in developing it

It is a common acceptance that contemporary schoolchildren live in a world that is intensely visual and commercially motivated, where what is imagined and what is experienced intermingle. Because of this, contemporary education should encourage a child to make reference to, and connection with their ‘out-of-school’ life. The core critical underpinnings of curriculum based arts appreciation and theory hinge on educators and students taking a historical look at the ways artists have engaged with, and made comment upon, their contemporary societies. My article uses this premise to argue for the need to persist with pushing for critique of/through the visual, that it be delivered as an active process via the arts classroom rather than as visual literacy, here regarded as a more passive process for interpreting and understanding visual material. The article asserts that visual arts lessons are best placed to provide fully students with such critique because they help students to develop a ’critical eye’, an interpretive lens often used by artists to view, analyse and independently navigate and respond to contemporary society.

Mother and child sharing through drawing: Intergenerational collaborative processes for making artworks

This paper presents a preliminary study into collaborated processes for art-making, undertaken by a young child and an adult. The study explores collaborative drawing in the context of sociocultural research into early childhood education. The study particularly examines whether childhood techniques for making marks, creative processing and art-making could be ‘re-learned’ by the adult, while new opportunities for expanding on extant repertoire could be available to the child. In this context the child teaches and learns from the adult, and the adult teaches and learns from the child. The study utilised video-data-recording to facilitate microanalysis of the researchers in action, enabling the adult researcher to present a discourse into the dynamics of how the visual, mark-making repertoires of an adult and child can be co-developed. Preliminary findings help contribute to the various discourses available into sociocultural research that supports processes for exploring and making art, and which allows a challenge to the role of the adult educator as a provider or director of what is learned.

Parents’ views about child sexual abuse prevention education : a systematic review

This paper presents the results of a systematic review of literature on the topic of parents’ views about child sexual abuse prevention education. It describes: i) what parents know about child sexual abuse prevention education; ii) what child sexual abuse prevention messages parents provide to their children and what topics they discuss; iii) what parents’ attitudes are towards child sexual abuse prevention education in schools; and iv) their preferences for content. Electronic database searches were conducted to identify relevant literature published in English relating to child sexual abuse prevention programs and parent’s views. A total of 429 papers were evaluated with 13 studies identified as meeting the study’s inclusion criteria. Worldwide, empirical research on parents’ views about child sexual abuse prevention programs is limited and more research is needed in Australia. Implications for future research and practice are outlined.

Locating child protection in preservice teacher education

A recent report delivered by the Australian Centre for Child Protection has highlighted the need for empirical evidence of effective pedagogies for supporting teaching and learning of child protection content in Australian teacher education programs (Arnold & Maio-Taddeo, 2007). This paper advances this call by presenting case study accounts of different approaches to teaching child protection content in University-based teacher education programs across three Australian States. These different cases provide a basis for understanding existing strategies as an important precursor to improving practice. Although preschool, primary and secondary schools have been involved in efforts to protect children from abuse and neglect since the 1970s, teacher education programs, including preservice and inservice programs, have been slow to align their work with child protection agendas. This paper opens a long-overdue discussion about the extent and nature of child protection content in teacher education and proposes strategies for translating research into practice.

Queensland College of Teachers annual lecture 2010 : child protection

Teachers have a crucial role as “sentinels” for children who have been abused or neglected. This professional development session will provide a framework for understanding the types, incidence and causes of child abuse and neglect, and teachers’ role in reporting suspected cases. The session will provide participants with knowledge and skills to enable them to identify warning signs and indicators of child abuse and neglect, know the basis of their duties to report suspected cases of abuse and neglect, and respond to the needs of abused and neglected children at school. The presentation will focus on: • the reasons why child abuse and neglect can occur; • the different types of child abuse and neglect and their effects on children; • the warning signs and indicators of physical abuse, emotional abuse, sexual abuse and neglect; • applying knowledge of indicators to make judgements about risk of harm; • responding to indications of risk of harm, including complying with legislative and policy-based duties to report suspected child abuse and neglect.