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Emerging results from the AEDI: implications for Australia's children

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1 Emerging results from the AEDI: implications for Australia's children
Associate Professor Sharon Goldfeld Paediatrician and Research Fellow Centre for Community Child Health, Royal Children's Hospital Murdoch Childrens Research Institute

2 (Stanley, Richardson & Prior, 2005)
“A society that is good to children is one with the smallest possible inequalities for children, with the vast majority of them having the same opportunities from birth for health, education, inclusion and participation.” (Stanley, Richardson & Prior, 2005)

3 Overview Why early childhood matters Why literacy matters
Why data matter Health and developmental inequalities in Australia: the results of the AEDI Community as a potential platform for change

4 Why early childhood matters

5 Brain development

6 Building strong foundations
Getting the foundations right is important – healthy brain development is a prerequisite for future health and wellbeing. Notes: Brain development is like building a house. Getting the foundations right is very important. The brain governs all our functioning, not just our cognitive processes. Brain development is important for all aspects of development - physical, social, emotional and cognitive. Therefore, healthy brain development is a prerequisite for our future physical and mental health, our social relationships, and our functional ‘real life’ skills, as well as our learning and academic achievements. Nurturing and responsive interactions build healthy brain architecture that provides a strong foundation for later learning, behavior, and health 6

7 Brain development [Slide option 2: No flash – static images]
Over 80% of synaptic growth occurs after birth We learn about and adapt to the particular environment into which we are born. Babies’ brains are ‘learning machines’: they build themselves, or adapt, to the environment at hand. Learning involves the strengthening of connections between particular neurons and the ‘pruning’ of others The early years of life matter because the interactive influences of both early experience and gene expression affect the architecture of the maturing brain As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all the health, learning and behavior that follow Brain development continues throughout childhood and adolescence but is most prolific in the pre-school years

8 Key experiences shaping health & development Early language and cognitive stimulation
During the first 24 months of life, children’s acquisition of language is highly associated with their mothers’ speech. By 2 years of age, children whose mothers speak to them the most have vocabularies that are eight times greater than those whose mothers speak to them the least. When given the right types and amounts of language and cognitive experiences, particularly within a warm and responsive social context, children from all walks of life gain in their intellectual and social-emotional competence. One of the really striking social gradient factors observed in the the LSAC finding on Australian children aged 2-3 years was the difference in the percentage of parents who reported reading to their children daily. For children in families with high SEP (i.e. the upper third) around 78% were read to on a daily basis; 60% of families with medium SEP were read to daily ; but in the low SEP families only 42% of children were read to daily.

9 Life course

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12 Developmental health opportunity
Ideal child-development trajectory Opportunity Current practice At-risk child-development trajectory without intervention Age 12

13 The ecology of child development
By understanding children’s development at school entry, communities can begin to examine the ecological or environmental factors that may be influencing child development outcomes in their community. The ‘ecological’ model of child development (see Figure 2) originates from Bronfenbrenner (1979). As the following illustrates, parents and family remain significant influences throughout childhood, but other environmental influences, such as peers and the school environment, also play a role. The larger social structure, economic, political and cultural environment impacts on the resources available to families and to children. The character of the communities in which children live, including the economic climate and accessibility of appropriate services, has significant influence on children’s development (Sanson et. al., 2002). 13

14 Economics of human capital

15 Return on investment in the early years
Reference: Cunha et. al., 2006. Investment in the early years of life before the formal school system, gives the greatest return. investing in the early years in cost effective are is associated with improved outcomes later in life. Gaps in child development trajectories stay mostly constant after eight years of age – that is, beyond the age of eight, school environments can only play a small role in reducing these gaps. Whilst it is never too late to invest efforts to shift developmental trajectories, the cost and effort required increase substantially after the early years period. 15

16 Impact of adversity early in life
Hackman D, Farah M, Meaney M. Socio economic status and the brain: mechanistic insights from human and animal research. Neuroscience. Vol ;

17 The Adverse Childhood Events (ACE) Study (N=17,000)
San Diego Kaiser adult patients Retrospective study of the relationship between morbidity patterns and adverse events in childhood, including Parental divorce Parental mental health Parental alcohol or drug abuse Physical/sexual abuse/neglect

18 If ACE score more than 4, then…
Smoking x 2 Alcoholism x 7 Cancer x 2 Heart disease x 2 Ch. lung disease x 4 Attempted suicide x12* I/V drug use (men) x 46* * Compared to ACE score of 0

19 Why literacy matters

20 The Current Situation The Australian Context
The Adult Literacy and Life Skills Survey 2006 Ages: 15 to 74 years Domain: Level 1 / 2 (%) Level 3 Level 4 / 5 Prose Literacy 46 37 16 Document Literacy 47 36 18 Problem Solving 70 25 5 Health Literacy 60 35 6 Just over half (53% and 54%) of Aust 15-74years have prose and document skills to meet the demands of everyday life and work There were small, but statistically significant changes achieved in prose and document literacy from 1996 for instance at level 1 for prose: 20% in 1996 to 17% in 2006, for document: 20% in 1996 to 18% in 2006 Higher proportion of older people attaining skills scores lower than level 3 Women had higher scores in prose and health literacy while men had higher scores in document literacy and numeracy Across all domains of literacy, people with jobs attained a higher skill level than unemployed or those not in the work force and in terms of income those with a higher level of skill in both prose and document literacy had a higher weekly income than their counterparts 50% of recent migrants whose first language was not English had document literacy skills to meet the needs of everyday life and work compared to 32% a decade ago Source:ABS Adult literacy and life skills survey, summary results report no (2006)(REISSUE)

21 Australia in the international context
Prose and Document Literacy Scale 2006 Ages: 16 to 65 years Country: Level 1 / 2 Level 3 Level 4 / 5 Domain: Prose (%) Doc (%) Prose (%) Doc Australia 44 39 37 18 19 Norway 34 32 45 40 21 28 Canada 42 43 20 United States 53 35 33 13 15 Italy 78 81 17 16 4 The prose and document literacy assessment with Norway, Canada, Australia, US, and Italy shows considerable difference in the proportion of the population performing at levels 4 and 5, level 3 and levels 1 and 2. Norway has the highest percentage performing at levels 4 and 5, and Italy has the smallest number performing at this level. In contrast, Italy’s population shows 78% and 81% at levels 1 and 2 which implies that they do not have a high performance literate population. In comparison with Norway, Canada and Australia have room for improvement. The weight of the evidence today is that if you do not have good early child development programs for all of your population, it will be difficult to improve the performance in literacy by the school system alone. Source ABS Adult literacy and life skills survey, summary results report no (2006)

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23 Language, literacy and social differences in Australia

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25 AEDI Domain comparison – vulnerability by SEIFA N=261,000

26 Disadvantage begins early in life ….
This chart describes the distribution of AEDI scores for Indigenous and non-Indigenous children in each state & territorry and for Australia. The percentage of children within each group who score below the 10th percentile of the national AEDI population is indicated by the size of the dark brown section of the bar; the percentage who score between the 10th and 25th percentile is shown by the orange section ; and the percentage who score above the 25th percentile is shown by the light ochre colour. To enable these distributions being compared with one another they have been along the point which corresponds to the median of the national AEDI population i.e. the score at which 50% of all Australian children score higher and another 50% score lower. So for example you can see that in the Northern Territiory around 80% of Indigenous children score below the national median whereas non-Indigenous children have a distribution of scores which corresponds closely with the distribution for all Australian children. The most striking thing about the relative positions of these distributions that they have an almost one-to-one correspondence with the pattern of the equivalent Year 3 NAPLAN jurisdictional distributions.

27 69% of NT Indigenous children score below national minimum standard

28 Targeting low-ses students v
Targeting low-ses students v. targeting low performing students Source: Masters (2009) using PISA data This graph presented by Masters (2009)

29 Why data matter

30 Data Evidence based policy Creating sustainable policy:
Recognition of the problem Identification of the solution through policy Evidence based policy Data Children on the policy agenda Political imperative Kingdon J. Agendas, Alternatives and Public Policies. 2nd ed. New York: Harper Collins College Publishers, 1995

31 Health and developmental inequalities in Australia: the results of the AEDI

32

33 About the AEDI

34 The AEDI is a relative population measure of how young children are developing in different Australian communities.

35 The AEDI looks at how groups of children are developing
It gathers information on each child… and reports back on how groups of children are developing. Alternative slide to explain population measure The AEDI is a population measure. 1)    It gathers information about every child 2)    It sorts the information according to where the children live, then 3)    It reports the information for each community. The AEDI does NOT: Score individual children as developmentally vulnerable or on track Identify children with specific learning disabilities or areas of developmental delay. Recommend which children should be placed in special education categories, who should receive extra classroom assistance, or whether children should be held back a grade. Recommend specific teaching approaches for individual children. Reflect the performance of the school or the quality of teaching.

36 What is the aim of the AEDI?
To measure the health and development of populations of young children to assist communities and governments to plan and assess the effectiveness of their efforts in supporting young children and their families. The AEDI aims to...

37 What does the AEDI measure?
[Option 2: static image, the five AEDI domains]

38 National implementation:
National data collection from 1 May to 31 July 2009 Data collected by teachers through a secure web based data entry system Schools provided with funding of 1 hour for teacher training and 30 minutes per completed checklist Data analysed and reported based on where children live AEDI were re-run in small communities in 2010.

39 Total = 261,203 children (97.5% of estimated population)
2009 snapshot of Australia’s children: Northern Territory: 3,255 Queensland: 55,449 WA: 27,579 NSW: 87,168 SA: 16,208 ACT: 4,432 Estimated population=estimated 5 year old population Victoria: 61,196 Tasmania: 5,916 Total = 261,203 children (97.5% of estimated population)

40 National Numbers Data collected on 261, 203 children (97.5%).
15,528 teachers from 7,423 schools (95.6% of all schools) participated. Teacher feedback (86.4% of all teachers, n=13,815): 90.1% found AEDI easy to complete 63.9% thought AEDI will be beneficial to their work 74.8% felt the AEDI will assist their community to better understand the health and development of children in their area Exact methodology and number of communities affected by the 2010 re-run to yet be determined-analyses currently underway

41 Demographic information
National Number of children surveyed 261,203 Aboriginal and Torres Strait Islander children 4.8% LBOTE (who speak languages other than or additional to English at home, or are reported by teachers to have ESL status) 18.0% Children with special needs status (chronic physical, intellectual and medical needs) 4.4% Children identified by teachers as requiring further assessment 10.5% 41

42 Key Findings Percentage of children developmentally vulnerable (DV) across Australia by jurisdiction DV on one or more domains (%) DV on two or more domains (%) Australia 23.3 11.7 New South Wales 21.2 10.2 Victoria 20.1 9.9 Queensland 29.2 15.6 Western Australia 24.3 12.0 South Australia 22.5 11.4 Tasmania 21.7 10.8 Northern Territory 36.3 22.1 Australian Capital Territory 21.9 Over three in four of our kids are developmentally on track on each of the domains  However some are not: 23.3% are developmentally vulnerable on one or more domain 11.7% are developmentally vulnerable on two or more domains Probably wouldn’t highlight state differences too much but it’s obvious who is worse-only NT can use indigenous statistics as any sort of mitigating factors Boys are not doing as well as girls-psychometric property and could be worth mentioning but with a caveat Indigenous are not doing as well as non-Indigenous Language diversity also has an impact Geographic location plays a part

43 Sub-population results
[Alternative to text slide - use script from above slide]

44 Socio-economic disadvantage
Demographic factors have a significant impact on the development of Australia’s children

45 Australian Indigenous children and SEIFA: Percentage developmental vulnerability
Demographic factors have a significant impact on the development of Australia’s children Green = Vulnerable on one or more domains Yellow = No vulnerability

46 Australian Indigenous children and SEIFA: Number developmentally vulnerable
Demographic factors have a significant impact on the development of Australia’s children Green = Vulnerable on one or more domains Yellow = No vulnerability

47 Results: gender POR Prevalence (%) Physical Social Emotional Lang/cog
Comm DV1 DV2 POR Boys 1.8 2.4 3.6 1.9 2.1 95% CI Prevalence (%) Boys (124,682) 11.8 12.0 13.5 11.3 11.7 30.1 16.2 Girls (122,550) 6.8 5.9 4.2 6.4 6.6 16.7 7.4

48 Results: gender POR Prevalence (%) Physical Social Emotional Lang/cog
Comm DV1 DV2 POR Boys 1.8 2.4 3.6 1.9 2.1 95% CI Prevalence (%) Boys (124,682) 11.8 12.0 13.5 11.3 11.7 30.1 16.2 Girls (122,550) 6.8 5.9 4.2 6.4 6.6 16.7 7.4

49 Results: language diversity
Physical Social Emotional Lang/cog Comm DV1 DV2 POR Lang Diverse 1.4 1.6 1.3 2.1 4.6 2.2 95% CI Prevalence (%) Lang div-yes (44,656) 12.2 13.7 10.8 15.0 25.4 37.8 20.0 Lang div-no (216,491) 8.9 8.6 8.0 6.8 21.4 10.6

50 Results: language diversity
Physical Social Emotional Lang/cog Comm DV1 DV2 POR Lang Diverse 1.4 1.6 1.3 2.1 4.6 2.2 95% CI Prevalence (%) Lang div-yes (44,656) 12.2 13.7 10.8 15.0 25.4 37.8 20.0 Lang div-no (216,491) 8.9 8.6 8.0 6.8 21.4 10.6

51 Results: ATSI POR Prevalence (%) Physical Social Emotional Lang/cog
Comm DV1 DV2 POR ATSI 2.9 2.6 2.2 4.7 3.1 3.4 95% CI Prevalence (%) ATSI-yes (12,416) 21.9 20.3 17.1 28.6 21.3 47.3 29.5 ATSI-no (248,731) 8.7 9.0 8.5 7.9 8.6 22.3 11.0

52 Results: ATSI POR Prevalence (%) Physical Social Emotional Lang/cog
Comm DV1 DV2 POR ATSI 2.9 2.6 2.2 4.7 3.1 3.4 95% CI Prevalence (%) ATSI-yes (12,416) 21.9 20.3 17.1 28.6 21.3 47.3 29.5 ATSI-no (248,731) 8.7 9.0 8.5 7.9 8.6 22.3 11.0

53 Results: SES POR Prevalence (%) Physical Social Emotional Lang/cog
Comm DV1 DV2 POR Poorest areas 2.4 2.3 2.0 3.3 2.9 2.8 95% CI Prevalence (%) (57, 650) 13.4 13.2 11.8 14.1 32.0 17.6 Richest areas (63,225) 6.1 6.2 6.3 4.7 5.4 16.2 7.2

54 Results Physical Social Emotional Lang/cog Comm DV1 DV2 Boys 1.8 2.4
3.6 1.9 2.1 Lang diversity 1.4 1.6 1.3 4.6 2.2 ATSI 2.9 2.6 4.7 3.1 3.4 Poorest areas 2.3 2 3.3 2.8 Preschool 1.7


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