Appendix -Supplemental material for A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder

<p>Supplemental material, Appendix for A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder by Amanda Brignell, Angela T Morgan, Susan Woolfenden, Felicity Klopper, Tamara May, Vanessa Sarkozy and Katrina Williams in Autism & Developmental Language Impairments</p

Reducing child mental health inequities through parental mental health and preschool attendance

Background Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services supporting treatment. We investigated the potential to reduce these inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Methods Data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5107, commencing in 2004) were used to examine the impact of socioeconomic disadvantage (0-1 year) on children’s mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities in children’s mental health problems could be reduced by improving disadvantaged children’s parental mental health (4-5 years) and their preschool attendance (4-5 years). Results Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their non-disadvantaged peers (18.7%): confounder-adjusted difference in prevalence=11.6% (95% CI: 7.7%-15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their non-disadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in child mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% CI: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Conclusions Targeted policy interventions that improve parent mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.</p

Reducing child mental health inequities through parental mental health and preschool attendance

Background Prevention is key to reducing socioeconomic inequities in children’s mental health problems, especially given limited availability and accessibility of services supporting treatment. We investigated the potential to reduce these inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Methods Data from the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5107, commencing in 2004) were used to examine the impact of socioeconomic disadvantage (0-1 year) on children’s mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities in children’s mental health problems could be reduced by improving disadvantaged children’s parental mental health (4-5 years) and their preschool attendance (4-5 years). Results Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their non-disadvantaged peers (18.7%): confounder-adjusted difference in prevalence=11.6% (95% CI: 7.7%-15.4%). Improving disadvantaged children’s parental mental health and their preschool attendance to the level of their non-disadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in child mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% CI: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Conclusions Targeted policy interventions that improve parent mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children’s mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.</p

Data_Sheet_1_Impact of integrated care coordination on pediatric asthma hospital presentations.pdf

IntroductionFrequent asthma attacks in children result in unscheduled hospital presentations. Patient centered care coordination can reduce asthma hospital presentations. In 2016, The Sydney Children's Hospitals Network launched the Asthma Follow up Integrated Care Initiative with the aim to reduce pediatric asthma emergency department (ED) presentations by 50% through developing and testing an integrated model of care led by care coordinators (CCs).MethodsThe integrated model of care was developed by a multidisciplinary team at Sydney Children's Hospital Randwick (SCH,R) and implemented in two phases: Phase I and Phase II. Children aged 2–16 years who presented ≥4 times to the ED of the SCH,R in the preceding 12 months were enrolled in Phase I and those who had ≥4 ED presentations and ≥1 hospital admissions with asthma attack were enrolled in Phase II. Phase I included a suite of interventions delivered by CCs including encouraging parents/carers to schedule follow-up visits with GP post-discharge, ensuring parents/carers are provided with standard asthma resource pack, offering referrals to asthma education sessions, sending a letter to the child's GP advising of the child's recent hospital presentation and coordinating asthma education webinar for GPs. In addition, in Phase II CCs sent text messages to parents/carers reminding them to follow-up with the child's GP. We compared the change in ED visits and hospital admissions at baseline (6 months pre-enrolment) and at 6-and 12-months post-enrolment in the program.ResultsDuring December 2016-January 2021, 160 children (99 in Phase I and 61 in Phase II) were enrolled. Compared to baseline at 6- and 12-months post-enrolment, the proportion of children requiring ≥1 asthma ED presentations reduced by 43 and 61% in Phase I and 41 and 66% in Phase II. Similarly, the proportion of children requiring ≥1 asthma hospital admissions at 6- and 12-months post-enrolment reduced by 40 and 47% in Phase I and 62 and 69% in Phase II.ConclusionOur results support that care coordinator led integrated model of asthma care which enables integration of acute and primary care services and provides families with asthma resources and education can reduce asthma hospital presentations in children.</p