The cost of healthcare for children with mental health difficulties

Objective: Childhood mental health difficulties affect one in every seven children in Australia, posing a potential financial burden to society. This paper reports on the early lifetime individual and population non-hospital healthcare costs to the Australian Federal Government for children experiencing mental health difficulties. It also reports on the use and cost of particular categories of service use, including the Medicare Benefits Schedule (MBS) mental health items introduced in 2006.

Physical activity of young children

Occupational therapists concerned with the long-term health and welfare of children need be aware of the decline in physical activity of children in most Western societies. The current study examined the extent of physical activity in the lives of 50 Australian children with mean age of 7.74 years through questionnaires completed by the children’s parents and pedometer (step) data collected from the children during 4 days. The current data show that higher self-perception of physical competence, child’s levels of physical skill, and low parental perception of peer teasing were the best predictors of physical activity. Higher family socioeconomic status was found to be a significant predictor of more steps being taken on weekends, and partner’s (usually a father’s) level of exercise was an important predictor of the number of weekend steps. Children who were perceived to experience more peer teasing completed fewer steps the weekend. The findings from this study indicate that children’s physical activity levels depend on the availability of family resources, and that children in their early school years already experience negative effects from teasing that, combined with reduced self-confidence, may lay the foundation for their withdrawing from physical activity as they get older.

Reasons for using web-based counselling among family and friends impacted by problem gambling

Despite the range of free services available in Australia, few family and friends of people with problem gambling access them. Over recent years, the Australian gambling help service system has expanded to include web-based counselling. Family and friends make up approximately 15% of people accessing this new modality, however little is known of the reasons for choosing this form of assistance over other interventions. This research aimed to understand the reasons family and friends choose to use single-session web-based counselling over other modes (i.e., face-to-face and telephone), as well as why they would recommend it to other affected people.

The study involved 63 participants (70% intimate partners, 13% children, 6% friends, 5% parents, 6% other family members) who completed openended questions on reasons for using and recommending web-based counselling, with over three-quarters of the sample seeking help for the first time.

A descriptive content analysis revealed multiple overlapping themes, including ease of access (41.3% of reasons for choosing), privacy and anonymity (17.5%), and a preference for the characteristics inherent in the therapeutic medium (23.8%). We also found webbased counselling provided a pathway into services (11.1%) and that the intervention provided was viewed as helpful and a reason for recommendation (34.9% of reasons for recommending).

This research provides important new information on the help seeking preferences of family and friends. Future research is required to understand the relationship between reasons for use, help-seeking preferences and the effectiveness of single-session web-based counselling for people affected by problem gambling.

An Iranian migrant mother's production of selves through her family photograph collection

In researching migrant identities, visual methodology offers much promise and yet there is a marked lack of recent research that makes use of visual methods. Previous studies of migrant identities have privileged verbal representations of identities. Gillian Rose's (2010) work with mothers and their family photographs in the United Kingdom, in which she describes the role of family photographs in both producing social subject positions and in maintaining family togetherness across distances, is a useful model for research into the construction and negotiation of migrant identities.

The literature on family photography suggests that it is usually the woman/mother who takes on the role of making the family photograph album; of narrating the family's story (Rose, 2010; Holland, 2009; 1991; Chambers, 2003). The family photograph collection, together with the participant's interwoven verbal interpretation, is a particularly relevant data source for use in identity research as there is the potential for key themes of place, mobilities and space to be explored at new depth and from a feminist perspective.

This paper will report on an ethics approved study of one Iranian migrant mother and her family photograph collection, focusing on her representation of the identities and subjectivities of herself and her children through photographs taken following migration to Australia. The paper will consider the participant's family photographs as both visual objects and visual-verbal narratives produced within historically and culturally situated discourses. It will explore how photographs and oral interpretations cohere to enable migrant mothers to re/produce selves. The paper will examine the production of subject positions specifically in relation to place, mobilities and space.

The research is situated within critical visual ethnography and is informed by a reflexive feminist approach. The meaning making of the photographs under study will be explored at the sites of production, image, and audience. The combined visual-verbal methods used in this study aim to provide a new contribution to the literature on migrant identities and form the basis of a scaled up research design of a larger cohort of mothers.

Migrant mothers: family photographs and the intra-active fashioning of a visual-material ethics

Migrant mothers play crucial roles within the social landscape of schools, particularly in providing care, education and a transition between home and school for their children. My research considers the relevance of theories of space, place, temporality and mobility in Iranian migrant mothers’ production of subjectivity for themselves and their children in and through their family photograph collections. Gillian Rose’s anthropological approach to visual objects is put to use in an exploration of the co-constitution of migrant women and their photographs. In this paper, I trace the shaping of a visual-material ethics within the research context and appropriate to the sensibilities and needs of the participant women who each moved from Iran to Australia with their children. Karen Barad’s notion of a posthumanist ‘ethics of mattering’ is drawn upon in conceptualising a visual-material ethics as fashioned in the intra-actions of people and visual objects. Specific ethical issues considered include the collaborative process of producing a family photograph, and the shaping and reshaping of images from photograph to line drawing to hybridised photograph-line drawing. A research ethics committee’s application of a liberal individualist, utilitarian and positivist biomedical paradigm in considering the research project is discussed as not only inadequate but also incompatible with the fashioning of a visual-material ethics in concert with the participant women and their photographs.

Parental factors associated with obesity in children with disability: a systematic review

The current literature on obesity in typically developing children shows that the family context, and specifically the way parents parent their children are major determinants of childhood obesity. The influence of these factors on obesity in children with disability, however, remains unclear. A systematic review of the literature was undertaken to identify the parental and parenting risk factors associated with obesity in children and adolescents with disability. Articles were identified through Medline, Academic Search Complete, PsycINFO, ProQuest, ISI, CINAHL, Cochrane and Scopus databases. There was no restriction on publication dates. The inclusion criteria were empirical papers that tested associations between parental and parenting risk factors and obesity in children and adolescents with intellectual and other developmental disabilities. Only 11 studies met the selection criteria and subsequently included in this review. Results suggest that obesity in children and adolescents with disability may be associated with socioeconomic status; parents' body mass index, perception and attitude towards their children's weight and physical activity; and levels of activity in both parents and children. Firm conclusions about these associations cannot be reached, however, due to mixed findings and methodological limitations of the studies. Recommendations for future research are provided.

Australia's digital policy : adopting a children's rights approach

  Children’s engagement with online technologies may seem second nature, yet the impact that the internet has on their lives is shaped by a powerful public policy agenda that largely overlooks children’s interests. Australia’s digital policy framework is dominated by discourses of safety and risk on the one hand and, on the other, neoliberal arguments about the possibilities for economic growth offered by e-commerce. In the midst of such powerful discourses it is difficult for children’s voices to be heard. This paper offers a close textual analysis of the Australian public policy context for regulating cyberspace. Finding a discursive duopoly that overlooks children’s interests, the author identifies two key features of a rights-based approach to challenge the dominant narratives currently serving the interests of the private sector and the State. 

A good place to raise a family? Comparing parents, service-providers', and media perspectives of the inner and outer suburban areas of Melbourne

In Australia, the suburbs have historically been the favoured place to raise children. However this is being challenged both by social change and government policy encouraging innerurban renewal. We examined how inner-urban areas compare with more traditional suburban locations as places to raise a family. Recognising that there are many influences on perceptions of place, we included the opinions of parents, service-providers and the media in the two locations.

Research focused on two municipalities in Melbourne, one located >25km and the other <10km from the CBD. Themes were obtained and compared from in-depth interviews with parents, serviceproviders and analysis of municipality-specific and state-wide newspaper articles.

Service provision was the only theme common at all levels of analysis. For all other themes, differences occurred between perspectives of service-providers, media and parents, as well as between the two residential locations. These in-depth snapshots on the challenges and rewards of raising children in different urban locations can help inform government in planning healthy neighbourhoods that better serve the needs of contemporary Australian families.

Challenges redoubled: contexts of risk and compromised access to services for children with sexualised behaviours

 Clinical studies indicate that children who engage in coercive or aggressive sexual acts are more likely to come from conditions of developmental adversity. Broadly speaking, the context of risk for children engaging in these behaviours aligns with particular indicators of social exclusion; geographic disadvantage, compromised family functioning and poverty. Children from such conditions of adversity are thought to be doubly compromised, as the context of risk that gave rise to the behaviours may also compromise families’ engagement with specialised therapeutic services to modify a child’s behaviours. In the absence of empirical data on the prevalence of problem sexual behaviours in Australia, this paper suggests that that scholarship and data collection underpinning the social inclusion policy agenda may inform the targeted delivery of secondary prevention strategies for children most at risk of engaging in problem sexual behaviours.

Above and beyond: exploring outcomes and practices of Scope Southern Region Early Childhood Intervention Service for children with disability

This research project is an exploration of the early childhood intervention service (ECIS) provided by Scope Southern Region. The research seeks to examine the benefits and outcomes for families and children. In doing so, the project’s emphasis is on key practices such as family centred practice and transdisciplinary practice, while examining the enablers and barriers to providing positive benefits to families and children. The central question is whether the interventions are of assistance to families and children.

When nutritional guidelines and life collide: family fruit and vegetable socialisation practices in low socioeconomic communities

Parents play a critical role in promoting fruit and vegetable consumption, for eating patterns established early in life tend to persist into adulthood. Despite this, the factors that facilitate or inhibit parents&rsquo; capacity to socialise fruit and vegetable consumption into their children&rsquo;s daily diets remain poorly defined. Thirty-eight semi-structured interviews with residents, allied healthcare professionals, community leaders, community programme leaders and a local government leader living or working in two low socioeconomic suburbs were consequently conducted to ascertain factors exogenous and endogenous to the family unit that shaped parental food socialisation practices. Budgetary and time constraints emerged as exogenous factors that constrained fruit and vegetable socialisation. Constraining effects were also found for a range of endogenous factors, including commensal experiences, children&rsquo;s food fussiness and the feeding styles employed by parents. As such, while many caregivers may wish to socialise fruit and vegetable consumption into their children&rsquo;s daily diets, their capacity to do so is often inhibited by factors beyond their volitional control. Failure to take heed of these factors could therefore result in the development of social marketing campaigns that are ineffective at best or give rise to unintentionally harmful outcomes at worst.

Australia's response to sexualised or sexually abusive behaviours in children and young people.

Responding to children and young people with sexualised or sexual offending behaviours presents significant challenges across the allied health, child protection, education and juvenile justice sectors. This report maps the specialised therapeutic services designed to effect positive behavioural change and thus divert young people with sexualised behaviours from the juvenile justice system. Accurate numbers on children with sexualised or sexual offending behaviours are difficult to determine. There are several factors contributing to this gap in understanding. These include entrenched ideals about children as inherently innocent, widespread ignorance about developmental sexuality, and the tendency of both young people and parents to deny or minimise incidents when they do occur.

In Australia, data on children with sexualised behaviours are not collected uniformly and nondisclosure contributes to what might be large numbers of offences going undetected. Mandatory reporting requirements apply where children display sexualised behaviours and are thought to be at risk of harm. Yet a general lack of knowledge as to what constitutes appropriate behaviour means that many may respond inappropriately to incidents of sexualised behaviours. This context of confusion, denial and non-disclosure creates a hidden population of children that continues to be at risk. Attention to redressing the contexts for non-disclosure is urgently required to ensure that children in need are provided with specialised therapeutic care.

This report presents qualitative data from interviews with specialised clinicians as well as submissions from service providers in both community and youth justice settings. In mapping the availability of therapeutic services, this report highlights a number of geographic and demographic gaps in service provision, including difficulties with eligibility criteria, referral pathways, funding arrangements and specialised workforce development. There are multiple challenges facing the tertiary services sector, yet the comprehensive provision of specialised services is just one part of the response required. This study emphasises the need for effective primary and secondary prevention to effect a reduction in the numbers of young people requiring counselling in the future. Consistent with the public health model, this report prioritises professional and community education strategies that would ultimately necessitate fewer tertiary services for young people and fewer places in juvenile detention centres.

Problem sexual behaviour in children: a review of the literature

   Although there is an under-acknowledgement of the issue in Australia there is a large body of international scholarship on juveniles who exhibit sexually violent or coercive behaviours toward other juveniles. Research undertaken in the United States and the United Kingdom emphasises options for clinical treatment, the logistics of coordinating multi agency response, and the causes and correlatives for coercive sexual behaviours in adolescents. Much of this literature has tended to focus on adolescents and there is an urgent need for increased studies on young children engaging in problem sexual behaviour.

   The smaller body of work published in Australia also favours adolescents rather than children with much of this work heavily influenced by international clinical studies. There are, however, a handful of reports based on Australian practitioner data that do focus on young children who engage in problem sexual behaviour. This literature surveys and evaluates the very limited number of existing therapeutic programs in Australia, and provides interview data with practitioners working with children exhibiting problem sexual behaviour. In the main, this research reinforces the findings of the internationa scholarship, both in terms of the contributing factors to problem sexual activity in children, but also in terms of the need for multi-faceted and contextually based cognitive behavioural therapeutic programs in response. More importantly, this burgeoning field of study indicates how far we have to go both in understanding the extent of the problem in Australia and in fashioning appropriate programs for prevention and intervention. Dr Joe Tucci is Chief Executive Officer of the Australian Childhood Foundation (ACF), an organisation that has taken a lead in responding to childhood problem sexual behaviour. Tucci et al., (2006) claim an urgent need for investment in a dedicated research and response agenda (Staiger et al., 2005b). To effectively address this issue researchers and practitioners require comprehensive empirical data on problem sexual behaviour in children across all sectors of Australian society, including Indigenous communities.