The Centre for Community Child Health About us and our recent work

March 2011 Contents

Director’s introduction 3 About us 4 Background 5 Structure 8 Clinical services 9 Research and public health 10 Community programs 12 Frank Oberklaid is the Foundation Translation 14 Director of the Centre for Community Professional development and training 15 Child Health at The Royal Children’s Hospital and a Professor within the Our recent work 16 University of Melbourne Department Ongoing projects 24 of Paediatrics. Publications 25 Our partner organisations 26

2 Title of section Director’s introduction

In recent decades there have In addition, there have been large tradition of being at the leading edge I am pleased that the Centre has been dramatic shifts in patterns documented increases in other of new developments in maintaining been able to attract and retain of children’s health. Developmental, conditions such as autism spectrum children’s health and treating illness. an outstanding group of people. behavioural and psychosocial disorders, school problems and Individually and collectively, they form The Centre for Community Child problems now comprise the majority ADHD. an incredibly valuable resource for the Health was established in order to of the workload of Australia’s hospital, the state and the country. These figures pose great challenges provide leadership to this increasingly paediatricians. Many of these The quality and commitment of our for policymakers and service important area of paediatrics. difficulties lie outside the boundaries staff, together with our ability to draw providers in our communities. These I am proud to have led such an of traditional medical care, and on the expertise of and collaboration challenges are compounded by inspirational and innovative team that, the vast majority are assessed with individuals and departments research suggesting that difficulty and in 1994, consisted of four people and managed in community and within The Royal Children’s Hospital dysfunction in children can have long- and has now grown to over 170 outpatient settings. The numbers and Murdoch Childrens Research term consequences, including the multidisciplinary staff. across Australia are staggering; Institute, constitutes a powerful precursors of adult conditions such recent data indicate that: The Centre’s work – clinical, research platform for the Centre’s efforts to as obesity, heart problems, mental and community programs – has make a difference to children and • up to 500,000 children and young health problems, criminality, family had a major influence on policy their families. people have a diagnosable mental violence, substance abuse and development and service delivery health condition social exclusion. at state and national levels. And, Frank Oberklaid • 300,000 are obese or seriously There are major implications of there is increasing interest from other Director, Centre for Community Child Health obese these findings for the training countries. Our clinical approaches The Royal Children’s Hospital Melbourne • there were over 350,000 child of paediatricians and other to common childhood conditions abuse notifications in 2009 professionals, for the way services are now standard, while our long- • almost 60,000 children started are organised and delivered in established training programs in school vulnerable in one or more community settings, and for the community child health have areas of development. evolving role of The Royal Children’s become models for paediatric Hospital, which has a long and proud training nationally.

CCCH Director’s introduction 3 About us

The Royal Children’s Hospital (RCH) We provide leadership in early of General Practice, the National Centre for Community Child Health is childhood and community health Accreditation Council, commited to supporting communities at community, state, national and National Community Child Health to improve the health, development international levels, and are widely Council, Australian Early Childhood and wellbeing of all children. recognised for our clinical, teaching, Association and relevant Government research and advocacy programs. Departments in health, education Established in 1994, we work in and family services. collaboration with our campus We have close links with individual partners – the Murdoch Childrens primary and secondary care Research Institute (MCRI) and the practitioners and with their relevant University of Melbourne – to integrate professional organisations, including clinical care, research and education the Royal Australasian College of in community child health. General Practitioners, Divisions

4 About us The Centre was established at the • increase the focus of community Background hospital in 1994, building on the child health in paediatric training previous Department of Ambulatory • develop a research program Paediatrics, to provide an academic incorporating both clinical and focus for community child health, population health approaches to and developmental and behavioural prevention and early intervention paediatrics. We also wanted to: • influence public policy and service delivery.

About us 5 Underpinning the Centre’s work, we believe that:

The early years of children’s lives have a significant Academic institutions can and should a major role impact on their physical, behavioural, educational and in contributing to public policy, as well as facilitating social development later in life. integration and continuity between preventive and curative health care, and between hospitals and community-based Many conditions and common problems in children are services. preventable or can result in better outcomes if they are recognised and managed early. Up-to-date research and evidence of what has shown to be effective and appropriate should inform policy The best results are achieved when professionals work formulation for children and families, the organisation in close partnership with who are supported and and delivery of clinical services, professional practice, empowered to make the best choices for their children. and . Supporting and strengthening community-based We have a responsibility to determine, using the most professionals and organisations ensures the best chance rigorous research designs, what prevention and early of good outcomes for children and their families. detection/intervention approaches work for children and families, and to document their benefits and costs.

6 About us Title of section 7 Structure We are a ‘vertically integrated’ Centre – our research • Clinical Services informs our clinical, translation and professional • Research and Public Health development work. We are made up of three closely • Community Programs linked operational units. The research and community projects conducted through the Centre are a collaboration with Murdoch Childrens Research Institute (MCRI) – the Centre’s research partner. The translation and professional development work of the Centre crosses all three units.

Additionally, the Centre has Centre for Community Child Health Director developed, implemented, and manages two major programs: the statewide Victorian Hearing Screening Program (VIHSP) and the Clinical Services Unit Research and Public Health Unit Community Programs Unit national Australian Early Development Index (AEDI).

• Paediatricians All research is Victorian Projects are Australian • Fellows conducted under Infant Hearing conducted under Early MCRI’s ‘Healthy Program MCRI’s ‘Healthy Development Development’ theme (VIHSP) Development’ Index • Mental health theme (AEDI) • Healthy weight • Community ‘Translation’ and • Language, literacy resourcing ‘Professional Development & hearing • Service development & Training’ cross all • Children • Research and policy three units

8 Structure Associate Professor Jill Sewell is the Director of Clinical Services and leads 16 paediatricians and the Centre’s nationally recognised paediatric training program in community child health.

Clinical services

Our Clinical Services Unit provides specialist clinics and specialist consultancy for children with a range of developmental and behavioural problems.

Weekly clinics include assessment and management of attention-deficit hyperactivity disorder (ADHD), learning difficulties and school problems, preschool developmental problems, communication disorders, unsettled babies, sleep problems, and enuresis and encopresis.

In 2010 there were eight advanced paediatric trainees in the Centre’s training program in community child health.

Clinical services 9 Research and public health

We conduct research into conditions and common problems faced by children, particularly those that are either preventable or that can be improved if recognised and managed early.

Professor Melissa The Centre’s research projects Our research agenda – focused Wake is the Director of are conducted under the ‘Healthy on public health strategies, health the Centre’s Research Development’ theme of MCRI. The promotion, prevention, early and Public Health unit, Research and Public Health Unit is intervention, screening and early leading around 40 researchers in both local organised around four major themes, detection – is driven by emerging and national projects, which also correspond with areas research evidence about the many of which started of research; these are: importance of the early years in over a decade ago. setting a child’s developmental • development, behaviour and trajectory and subsequent life mental health course. We aim to gain a better • hearing understanding of the causal pathways • language, learning and literacy and trends leading to development • obesity. and behavioural problems in children in order to develop effective management strategies that can be employed in community settings. The Victorian Infant Hearing Screening Program (VIHSP)

There are over 100 Centre staff in the VIHSP team, working across Victoria. VIHSP is directed by Drs Zeffie Poulakis and Melinda Barker and expanded in 2010 to now screen the hearing of over 90% of Victorian newborns.

Research and public health 11 Community programs We are strongly committed to supporting and strengthening community-based professionals and organisations in their work with families. The Community Programs unit works closely with communities to help them bring about the best outcomes for children.

Mary Sayers is the Director of the Community Programs Unit, and leads a multidisciplinary team of over 40 professional staff working across across five areas: Community Resourcing, Service Development, Translation, Research and Policy and the Australian Early Development Index. Community resourcing Service development Australian Early Research and Policy

Community-based services are under There is growing evidence that Development Index Led by Dr Tim Moore, Senior increasing pressure to demonstrate today’s services need to be The AEDI, led by National Director Research Fellow, the focus of the the effectiveness of the programs reconfigured if we are to achieve Dr Sharon Goldfeld, aims to provide research and policy work is to search they provide to improve child and better outcomes for young children. communities and policy makers with for, synthesise, and help translate family outcomes. Our community Our service development team community level information about the research evidence to enable resourcing team evaluates programs, facilitates community partnership the developmental profiles of children governments, service systems and services and systems to help groups to develop tailored strategies at school entry; communities can use individual services to adopt policies determine what works and what that help local services work their data to develop and re-orient that are based upon best evidence, doesn’t, and to assist in planning the together to optimise the outcomes services and systems to improve the best practice and program logic. future of early childhood programs. for children and their families. health, wellbeing and early learning of young children.

Community programs 13 Translation

Central to our mission to improve the health and wellbeing of children is our commitment to translating and disseminating research in order to:

• influence early childhood policy • support parents in their important role • assist professionals to support parents • empower communities to strengthen and refocus services for young children and their families.

The Translation team works to translate the work of the Centre into practice via the Centre’s three national peer-reviewed publications, the Centre-run websites, and by assisting the Centre’s various teams with their translation activities and communications strategies.

14 Translation Professional development and training

We provide a variety of professional development opportunities as well as training for professionals who work with children across all three of our units.

Research and Clinical Services Unit Community

Public Health Unit The Victorian Training Program in Programs Unit • Let’s Read training for family Community Child Health provides a The Programs Unit conducts a and child health nurses 12 month fellowship in community range of courses and seminars child health with funding from the • LEAP and HopSCOTCH training aimed particularly at early childhood Victorian Department of Health and in managing children’s obesity educators and carers and family the Commonwealth Department of for general practitioners and child health nurses, as well as Health and Ageing Specialist Training professionals working with children, • Infant Sleep training for family Program. All paediatric training and local government. The Centre and child health nurses. positions are accredited by the Royal also offers an elective unit in child Australian College of Physicians for health as a component of Melbourne advanced training in community University’s Masters in Public Health. child health. • Parents’ Evaluation of • Professional Development Developmental Status Program, an annual two-day • Family Partnership training workshop format for practising • The R.E. Ross Trust Early Years paediatricians seminars • The Centre’s clinical staff are • Integrated Service Development involved in regularly contributing to training and seminars a variety of community and hospital lectures, seminars and professional • Best Start Platforms training. development programs.

Professional development and training 15 Our recent work 2009–2010

The Centre for Community Child Health is part of more projects than we have room for on these pages. Please visit www.rch.org.au/CCCH for more information on our current and completed projects.

Australian Early Development Index (AEDI)

The AEDI project set out to collect Data about five key areas of child population data on children’s development – such as physical development in their early years. development, language skills and Following a very successful pilot communication skills – can be found which commenced in 2004, the as maps and reports on the AEDI Australian Government provided website. Australia is the only country $24.5 million to collect AEDI data in the world to have national data of nationwide. In 2009 the AEDI was this type available to communities. completed for 261,203 Australian The AEDI has been endorsed by the children (98% of the eligible Council of Australian Governments population) in their first year of as a national progress measure of full-time school. children’s development.

Now for the very first time Australia The Australian Government and State has information about early and Territory Governments work in childhood development in individual partnership with our Centre and the communities. Telethon Institute for Child Health Research, Perth, to deliver the AEDI.

www.aedi.org.au

16 Our recent work APRN Centre publications Baby Business

Launched in 2007, the Australian The Centre produces three national Infant sleep and crying problems are Paediatric Research Network is a publications: Community Paediatric the most common reason parents network of almost 400 practising Review (for family and child health present to health professionals in paediatricians who are keen to nurses), Childcare and Children’s the first few months of life; these contribute to new research that is Health (for early childhood educators) problems also double the risk of relevant to both public and private and Policy Briefs (for policy makers postnatal depression. Baby Business practice. The network focuses on at local, state and national levels). is a randomised controlled trial of common paediatric problems and The publications have a combined a universal parenting program that is committed to generating new Advisory Board to provide input and is designed to prevent infant sleep knowledge, promoting better clinical direction, and then each publication and cry problems and associated practice and informing child health has an Editorial Board to oversee maternal postnatal depression, care policy and guidelines. the content of each issue and provide in the first six months of peer review. The publications are life. The program aims www.aprn.org.au distributed as hard copies and are to teach parents about also available online. normal infant sleep

and cry patterns, sleep

www.rch.org.au/ccch/resources.cfm

and settling strategies,

and medical causes of

www.rch.org.au/ccch Community PaediatriC review

prolonged crying. Baby Volume 18 N0 1

July 2010

executiVe iNdex

uSe of caNNabiS iN pregNaNcy aNd aS a New uSe of Business is a joint project caNNabiS iN 1 pregNaNcy aNd iNtroductioN aS a New pareNt The most common illicit drug used by

women of reproductive age and by pregnant oVer View of pareNtal drug women is cannabis (DrugInfo, 2005). uSe – iSSueS for practice between the Centre and the

Although there are limited national data There are significant challenges in caring for available on illicit substance use among families where parental substance abuse has parents in Australia, the 2007 National an impact on their capacity to care for their Drug Strategy Household Survey estimated baby. When assessing the family situation 12% of parents with children aged 0–14 and the needs of the child, the maternal Parenting Research Centre years used either an illicit substance child and family health nurse needs to (such as marijuana or ecstasy) or a licit consider: substance (such as painkillers) for non- medical purposes in the previous 12 months • the direct effects of the drug use on the

(Australian Institute of Health and Welfare developing fetus (Victoria). [AIHW], 2009). • the likelihood that parents with drug and

“Maternal substance abuse is a potent risk alcohol problems have particular traits

condition” (Boris in Zeanah, 2000) as infant that influence parenting behaviour development can be affected by interrelated • the fact that parental substance abuse mechanisms that are all clinically important; is often linked to other risk factors that These can be: impact on the baby’s social environment

• direct prenatal effects (Boris in Zeanah, 2000).

• genetic effects (that influence both When considering these factors, it is

parent and infant) essential to remember that the baby and its

family must be supported antenatally – via • cumulative social risks. family, friends and services – through the For maternal child and family health nurses, early years of life in order for the child to identification and early intervention through achieve optimal growth and development in active engagement is a priority. It is also the best possible environment. essential to have knowledge of alcohol and Healthy child development drug use, its impact on the user and the

baby, and what this means for the parents’ A healthy pregnancy is essential for healthy

capacity to care for their infant. This article fetal development. ‘Prenatal maternal

will address these issues and provide an nutrition, exposures and behaviours are

update about cannabis use. controllable factors that may impact both

the fetal brain development and later

neurodevelopmental outcomes’ (Massaro, Rothbaum, 2006). As with other areas of An initiative of the Centre for Community Child Health, The Royal Children’s Hospital, Melbourne

Our recent work 17 The Children with Families in Mind Get up and Grow

Hearing Impairment in Families in Mind aims to help prevent In 2008–2009, we partnered with Victoria Outcome Study externalising behaviour problems The Royal Children’s Hospital’s (CHIVOS) in the preschool child, such as Nutrition Department and Early oppositional defiance, hyperactivity Childhood Australia to develop the Internationally, CHIVOS is the longest and aggression. Families in Mind Healthy Eating and Physical Activity population study of congenital is a randomised trial that examines Guidelines for Early Childhood for the hearing loss. Since it started in 1997, whether combining two programs Department of Health and Ageing. CHIVOS has assessed 88 children – a brief group parenting program Get up and Grow aims to promote at 7–8 and 12–13 years. We are and a targeted one-on-one family and support healthy eating and now determining what early factors support program (delivered by clinical physical activity in young children in most affect quality of life, language, psychologists and other trained Early Childhood Education and Care academic skills, physical and mental health professionals) – is more (ECEC) services, and is part of the health and life views at 17–18 years. effective than one program alone. government’s plan to tackle obesity. CHIVOS has important implications Get up and Grow consists of a suite for deaf children who are born today. of evidence-based resources to support ECEC staff; these include learning through Active play books written specifically for setting directors, staff and caregivers, water: a healthy and essential cooks and parents, as well as parent drink brochures, posters and inserts for Families in Mind Get up and Grow newsletters.

GET UP & GROW HEALTHY EATING AND PHYSICAL ACTIVITY FOR EARLY CHILDHOOD

GET UP & GROW HEALTHY EATING AND PHYSICAL ACTIVITY FOR EARLY CHILDHOOD

18 Our recent work Integrated Service LEAP

Development The aim of the Live, Eat and Play The Integrated Service Development (LEAP2) project is to trial a new project aims to meet the service strategy to reduce the weight of needs of all Victorian children and overweight Victorian primary children. families by developing sustainable It involved training GPs in healthy integrated service models to individual family lifestyle counselling and offering children’s centres. The project is families in the ‘intervention’ group based on the best international consultations to discuss lifestyle evidence and is also consistent with changes and supporting resources. the Victorian Government’s priorities The trial started in 2005 and the outlined in the Blueprint for Education three year follow-up data and Early Childhood development. Hopscotch collection was completed in 2010. To establish the Integrated Service HopSCOTCH is a randomised Centres, we partner with community- controlled trial for a ‘shared care’ based organisations, schools, approach to weight management local government and the Victorian in children from age 3 to 10 years. Department of Education and The shared care approach involves Early Childhood Development to GPs working with the RCH specialist work directly with service providers obesity team. The trial aims to and early childhood practitioner evaluate whether this approach to services. This work is now attracting weight management is feasible in considerable national and terms of both outcomes and costs. international attention.

Our recent work 19 Let’s Learn Language Language 4 Learning

The early years constitute an Our understanding of how language important window of opportunity for develops has changed considerably effective promotion of language in over the last three years. Researchers children at risk of language delay. used to think that most preschoolers Of the many children who are slow to with language delay were late talkers start talking, around a third will have as toddlers, however we now know language delay at age four years, that many of these children actually often with lifelong consequences. start talking at the usual age. Finding The Let’s Learn Language trial the children with language delays offers a community-wide program and offering help could provide them to parents of toddlers who are slow with a better start to school. The aim Let’s Read to speak. It aims to determine whether of Language 4 Learning is to trial Let’s Read is a national initiative to such a program can improve early a population approach to improve promote reading with young children language production, in the hope that language and related outcomes from birth to five years. Delivered in this will reduce later language delay. in four-year olds with language partnership with The Smith Family, delay. Language for Learning is a Let’s Read has a presence in 93 randomised controlled trial. communities across Australia and has supported literacy development in over 100,000 families since its inception. In 2009–10 Let’s Read developed a more sustainable approach to training community professionals, expanded its community presence, developed a discussion paper on engagement with Indigenous communities and completed several community evaluation reports.

20 Title of section Linking Schools and Raising Children Network

Early Years The Centre is one of a three- Our Linking Schools and Early Years member consortium that conceived, project works with schools and developed and manages the award- communities to develop new models winning parent information website of working collaboratively to ensure Raising Children Network (RCN), that all children enter the formal funded by the Commonwealth education system ready to engage Government. The website has a with their new learning environment. growing repository of over 800 In 2009–10, the project welcomed science-based and peer-reviewed investment from the Victorian articles on child health, mental health, Department of Education and Early behaviour and development. It also Childhood Development to build on has additional information for parents the philanthropic support from The of children with a disability and those R.E. Ross Trust and the Foundation with autism spectrum disorders. for Young Australians. Its content caters to families from a wide range of backgrounds and abilities with graphic-rich and audio- visual materials such as Parenting in Pictures and videos. We have recently partnered with The Royal Children’s Hospital’s Centre for Adolescent Health to expand the website to include information on adolescence.

www.raisingchildren.net.au

Our recent work 21 State-wide Comparison Sleep Well – Be Well

of Outcomes (SCOUT) Australian studies have shown that The SCOUT study examines the sleep problems adversely affect costs, benefits and cost-effectiveness a child’s learning, behaviour and of detecting hearing loss early, either academic performance. However, by universal newborn screening or the impact on these outcomes by risk factor screening. It targets of improving sleep is unknown. all children born with hearing loss in The Sleep Well – Be Well trial NSW and VIC between 2003 and is the world’s first randomised 2005. SCOUT is a major collaborative controlled trial to address sleep research project funded by Australia’s problems in a child’s first year of National Health and Medical school. Commencing in 2008 in Research Council and partners with 22 Melbourne schools, a brief a senior population child health intervention – providing parents with economist from Deakin University. simple behavioural sleep strategies and information about normal child sleep requirements – reduced child sleep problems and improved child emotional and social wellbeing and mental health symptoms.

22 Our recent work Tasmanian links VIHSP

The Centre prides itself on its The Victorian Infant Hearing Australia-wide reputation. In 2009 Screening Program (VIHSP) screens we entered into a partnership with the hearing of newborn babies with the Tasmanian Early Years Foundation the aim to detect hearing loss early. and the Tasmanian Government to The screen is performed by trained take the lead on the design and hearing screeners using standard implementation of a Learning and technology and is most often done at Development Strategy to support the the baby’s bedside in the days after roll-out of up to 30 integrated Child birth. Having established the service and Family Centres across Tasmania. in all metropolitan public hospitals We also successfully tendered for in 2008, 57% of Victorian babies the facilitation of a two-year Action (21,956) were able to be screened. Project for the Child and Family In 2010 the program expanded to Centres project. Both the Learning provide all maternity hospitals with and Development Strategy and hearing screening, allowing over 90% the Action Research projects are of Victorian to access VIHSP funded by the Tasmanian Early Years as of December 2010. Foundation. We now have a small www.rch.org.au/vihsp team of staff working in Tasmania.

Our recent work 23 Ongoing projects

For details of the following ongoing projects of the Centre, as well as our completed projects, please visit www.rch.org.au/ccch

AEDI Process Evaluation Infant Sleep Study Australian Paediatric Research Network Let’s Learn Language Study Baby Business Let’s Read Baptcare Learn, Play, Talk program Longitudinal Study of Australian Children (Growing Up in Australia) Best Start and local government evaluation projects Maternal Child Health – Key Ages and Stages evaluation Best Start Evaluation Projects Moreland Healthy Children Project Blue Sky research project Parent Education and Support (PEAS) Children Protection Society evaluation of child and family program Platforms Service Redevelopment Framework Communities for Children evaluation and research support RCN Evaluation Doveton Connect Sleeping Sound with ADHD Early Childhood Connections START evaluation Families in Mind study Tasmania Child and Family Centre action research project Good Beginnings Australia Evaluation Redevelopment Toddlers Without Tears Healthy eating Victorian Children Centres – Support for Integration

24 Ongoing projects Publications

Conducting comprehensive literature reviews is a key component of many of our research, policy Congratulations and translation projects. The Centre is proud of all of its staff and their achievements. In the past 18 months, our staff have been awarded numerous prestigious prizes, grants, tenders and fellowships that recognise the work the Centre carries out to improve children’s health and wellbeing. Regardless of the topic at hand, a Staff at the Centre also publish detailed review and documentation extensively in a range of journals, We have also been appointed to a number of of available literature and research reports and publications including esteemed positions on a variety of boards, trusts evidence is often the first and most Journal of Adolescent Health, and councils, including government panels. critical step in a successful project. , American Pediatrics, Early www.rch.org.au/ccch Education and Development and In the 12 months to December 2010, Paediatrics and Child Health. we published a total of 10 editions of the Centre’s three publications: www.rch.org.au/ccch/resources.cfm Policy Briefs, Community Paediatric Review and Childcare and Children’s Health. The topics covered ranged from television and early childhood development, to cannabis use by parents, to grandparents and child care.

Publications 25 Our partner organisations We would like to thank our many partners and collaborators for their ongoing support of our work to improve children’s health and wellbeing.

Government Non government Australian Bureau of Statistics organisations Department of Education (Tasmania) Children’s Protection Society Department of Education and Early Community Child Care Victoria Childhood Development (Victoria), Foundation for Children which includes maternal and child health and other early childhood Parenting Research Centre services The R.E. Ross Trust Department of Education, The Smith Family Employment and Workplace Tasmanian Early Years Foundation Relations (Commonwealth) Department of Health (Victoria) Professional Department of Health and Ageing organisations (Commonwealth) Royal Australasian College Department of Families, Housing, of Physicians (RACP) Community Services and Indigenous Royal Australian College Affairs (Commonwealth) of General Practitioners (RACGP) Department of Premier and Cabinet – Children’s Services (Victoria) Corporate Municipal Association of Victoria Coles Baby Club National Acoustic Laboratories Johnson and Johnson Tasmanian Early Years Foundation Orica Shell Australia

26 Title of section Education Institutes Research Institutes Australian Institute of Family Studies Telethon Institute for Child Education Institute, at The Royal Health Research Children’s Hospital Melbourne Menzies School of Health Deakin University Research LaTrobe University Monash University Newcastle University (UK) RMIT University University of Adelaide University of British Columbia (Vancouver, Canada) University of California, Los Angeles – UCLA (US) University of Melbourne University of Otago (New Zealand) University of Pittsburgh (US) University of Toronto (Canada)

Partner organisations 27 The Centre for Community Child Health The Royal Children’s Hospital Melbourne 6th Floor, South-East Building 50 Flemington Road Parkville, Victoria 3052 Telephone +61 3 9345 6150 Facsimile +61 3 9345 5900 Email [email protected] www.rch.org.au/ccch

28 Title of section ERC 101167