State Findings from the School Entrant Health Questionnaire

State findings from the School Entrant Health Questionnaire 2012 to 2014

Department of Education and Training 1 Published by the Performance and Evaluation Division Department of Education and Training Melbourne June 2015

©State of Victoria (Department of Education and Training) 2015

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Authorised by the Department of Education and Training, 2 Treasury Place, East Melbourne, Victoria, 3002. ISBN [to be inserted if required] This document is also available on the internet at Department of Education's website research page

Department of Education and Training 2 Contents

Department of Education and Training 3 The School Entrant Health Questionnaire (SEHQ) is a parent1 report instrument that records parent’s concerns and observations about their child’s health and wellbeing during their child’s first year at primary school. The questionnaire was developed and piloted in 1996-97 and has been completed by parents and guardians of preparatory (Prep) grade children in Victorian primary schools since mid-1997 through the Victorian Primary School Nursing Program (PSNP)2. The intention of the questionnaire is to gather information on parental concerns to identify potential health and wellbeing issues that may impact on a child’s capacity to learn. The information collected in the SEHQ is a starting point for nurses to carry out further assessment of the child and family and determine appropriate intervention and/or referral as required. Analysis of the SEHQ data is also used to inform planning and service delivery.

Purpose of this report The primary purpose of this report is to examine data from the 2014 SEHQ as well as providing some longitudinal analysis relating to the period of 2012 to 2014, highlighting emerging trends.

Distribution of the SEHQ In 2014 there were 63,391 responses to the School Entry Health Questionnaire (SEHQ). Table 1 shows an increase in the number of school entrants, and those with a completed SEHQ from 2011 to 2013. Numbers of enrolments and SEHQ responses remained stable between 2013 and 2014. Table 1 shows the distribution and completion of the SEHQ across Victoria highlighting that 85 per cent of the school entrant population in Victoria had a SEHQ completed in 2014 (across all school sectors). The response rates are slightly higher for Government schools (88 per cent).

Table 1: Number of SEHQ responses and prep enrolments, Victoria 2011-2014 Profile 2011 2012 2013 2014 Number of 69,453 73,100 74,914 74,826 children enrolled in Prep Number of 58,970 60,478 63,935 63,391 children surveyed Proportion of 84.9% 82.7% 85.3% 84.7% school entrants surveyed - All schools

1 In all cases ‘parent’ refers to the person completing the questionnaire; this may be a guardian, carer, grandparent, etc 2 Not all schools participate in the PSNP; only children in participating schools will have a SEHQ completed by a parent.

Department of Education and Training 4 Key statistics at a glance Area 2014 Trend Cohorts/areas of note value (from 2012) Children born 8.3%  0.3% outside Australia Children that speak 13.9%  1.3% a language other than English at home Children that live in 20.8%  0.4% 43% of Aboriginal children; 35% of an area of most children with a language other than disadvantage English; 32% of children that live in regional/rural areas; 31% of children in one-parent families General health – 88.4% 0.9% parents that rate their child’s health as excellent/very good Weight –parents 2.2%  0.4% Children in one – parent families most who perceive their perceived to be overweight while child to be children with a language other than overweight English most perceived to be underweight Asthma – children 13.8% 1.1% Rates are higher in Aboriginal children who have an asthma diagnosis Allergy – children 10.5% 0.7% who have been told by a doctor that they have an allergy Speech and 14.2%  0.4% Increase for Aboriginal children More language –parents boys than girls are affected that reported speech or language difficulties in their children Vision–parents that 8.0%  0.2% Decrease for children with a language reported concerns other than English and children living with their child’s in the most disadvantaged areas while vision increase for children living in rural/regional areas Oral health–parents 14.5%  Increase for Aboriginal children that reported

Department of Education and Training 5 Area 2014 Trend Cohorts/areas of note value (from 2012) concerns with their child’s oral health General 14.7%  1.2% Highest proportions of high risk development – children are Aboriginal and children children at high risk from one-parent families of developmental and/or behavioural problems Behavioural and 4.6%  0.3% Aboriginal cohort highest at high risk emotional wellbeing and increase in at high risk children –children at high from one-parent families risk of clinically significant problems related to behaviour Family stress – 11.0% 0.4% Increase for those living in areas of families reporting least disadvantage high levels of stress

Department of Education and Training 6 Demographic profile of children at school entry

Child and family characteristics The SEHQ gathers demographic information about children entering school. Table 2 displays demographic information, as reported by parents.

Table 2: Demographic profile of children beginning school, Victoria 2012-2014 Population group 2012 2013 2014 2014 Number 5 years of age (at April 30 of 77.7% 77.6% 78.4% 49,724 survey year) 6 Years (at April 30 of survey 16.6% 16.3% 15.9% 10,050 year) Boys 49.6% 49.4% 49.3% 31,236 Girls 47.4% 46.9% 47.2% 29,895 Born outside Australia 8.0% 8.0% 8.3% 5,261 Lives in rural or regional 28.4% 27.5% 27.2% 17,222 area Lives in a metropolitan area 71.5% 72.4% 72.8% 46,121 One-parent families 12.4% 12.1% 12.0% 7,625 With a language other than 12.6% 13.2% 13.9% 8,804 English Aboriginal or Torres Strait 1.5% 1.6% 1.6% 1,017 Islander origins Lives in area of most IRSD 21.0% 20.4% 20.8% 13,180 disadvantage Lives in area of least IRSD 21.5% 21.9% 21.5% 13,660 disadvantage Note: categories will not sum to ‘all children’ due to missing or invalid data

Disadvantage To represent findings from the SEHQ at a socio-economic level, Socio-Economic Index for Areas (SEIFA) has been used3. The SEIFA, which was developed by the Australian Bureau of Statistics using 2011 census information, is derived from a set of social and economic information. One of these sets, the Index of Relative Socio- economic Disadvantage (IRSD) focuses on disadvantage, including factors such as low income, low education attainment, unemployment, and dwellings without motor vehicles.

3 Australian Bureau of Statistics

Department of Education and Training 7 In this report, socio-economic disadvantage is shown using the quintiles of the IRSD. These quintiles demonstrate the relative SEIFA scores (based on the IRSD) by geographical areas, with quintile 1 representing the lowest 20 per cent of scores and quintile 5 the highest. This means that children living in an area with an IRSD quintile of 1 are living in an area that is ranked in the lowest 20 per cent of all areas (the most disadvantaged). On the other hand, children living in an area with an IRSD quintile of 5 are living in an area that is ranked within the top 20 per cent (the least disadvantaged). From the 2014 SEHQ responses, 20.8 per cent of children live in areas of most disadvantage (quintile 1) and 21.5 per cent live in areas of least disadvantage (quintile 5). There is a significant difference in proportions of children living in rural and metropolitan areas across the quintiles, with children in rural/regional areas more likely to live in an area of disadvantage than children living in metropolitan areas. This trend is consistent with previous years. Children with a language background other than English and Aboriginal and Torres Strait Islander children are also more likely to live in areas designated as most disadvantaged. There is little difference between the distribution of boys and girls across the quintiles.

Table 3: Proportional distribution of children across IRSD SEIFA quintiles, by population groups, Victoria 2014 with most disadvantaged being quintile 1 and the least disadvantage being quintile 5. Population group IRSD IRSD IRSD IRSD IRSD quintile 1 quintile 2 quintile 3 quintile 4 quintile 5 All Children 20.8% 18.3% 20.0% 19.2% 21.5% Language background 35.3% 16.7% 19.7% 12.9% 15.5% other than English Aboriginal or Torres 42.5% 27.0% 14.8% 10.1% 5.3% Strait Islander One-parent family 31.3% 22.5% 19.7% 14.3% 12.1% Boys 20.8% 18.5% 20.1% 19.5% 21.0% Girls 21.2% 18.4% 20.1% 19.2% 21.0% Rural/Regional areas 31.8% 29.7% 15.9% 17.9% 4.6% Metropolitan areas 16.7% 14.1% 21.6% 19.7% 27.9%

Department of Education and Training 8 Department of Education and Training 9 General Health

Overall Health Almost 89 per cent of parents from 2012 to 2014 consistently reported that their child’s health was either excellent or very good. Tables 4a - 4c show that amongst at risk population groups4, parents were less likely to report the health of their child as excellent or very good, particularly those with a language background other than English. There was little difference between the reported health of boy and girls and children from rural/regional and metropolitan areas. Fair/poor health is more likely to be reported by parents of Aboriginal or Torres Strait Islander children and children in one-parent families. While in 2012, children with a language background other than English were the most likely to be reported as having fair/poor health (2.1 per cent), this reduced to 1.3 per cent in 2014.

4 Children are acknowledged as being in a population at risk if they one or more of the following characteristics: a language background other than English; are of Aboriginal or Torres Strait Islander origin; live in a one-parent family; and/or live in an area of most socio-economic disadvantage. For more information refer to Outcomes for Victorian children at school entry (2011) section 3.4 Department of Education website SEHQ report

Department of Education and Training 10 Table 4a: Parental perception of child's health, by population groups, Victoria, 2012- 2014 (Excellent/very good) Population group 2012 2013 2014 2014 All Children 89.3% 88.8% 88.4% 56,022 Language background other 81.0% 81.8% 82.6% 7,276 than English Aboriginal or Torres Strait 84.8% 86.4% 86.5% 880 Islander Areas of most disadvantage 86.7% 86.4% 85.4% 11,256 (IRSD 1) Areas of least disadvantage 89.9% 88.9% 88.3% 12,064 (IRSD 5) One-parent family 88.7% 89.2% 89.2% 6,803 Boys 90.6% 90.7% 90.5% 28,258 Girls 92.5% 92.6% 92.0% 27,501 Rural/regional areas 91.0% 91.3% 91.2% 15,701 Metropolitan areas 88.6% 87.8% 87.3% 40,280 Note: categories will not sum to ‘all children’ due to missing or invalid data

Table 4b: Parental perception of child's health, by population groups, Victoria, 2012- 2014 (Good) 2014 Population group 2012 2013 2014 number All Children 6.7% 6.6% 6.7% 4,239 Language background other 16.3% 16.0% 15.3% 1,345 than English Aboriginal or Torres Strait 11.4% 10.6% 9.4% 96 Islander Areas of most disadvantage 9.2% 9.1% 9.1% 1,199 (IRSD 1) Areas of least disadvantage 5.1% 5.1% 5.2% 712 (IRSD 5) One-parent family 9.4% 8.8% 8.6% 656 Boys 7.5% 7.6% 7.5% 2,333 Girls 6.1% 5.9% 6.3% 1,886 Rural/Regional areas 5.5% 5.1% 5.1% 873 Metropolitan areas 7.2% 7.2% 7.3% 3,365 Note: categories will not sum to ‘all children’ due to missing or invalid data

Table 4c: Parental perception of child's health, by population groups, Victoria, 2012-2014 (Fair/Poor) Population group 2012 2013 2014 2014 All Children 0.9% 0.8% 0.7% 471

Department of Education and Training 11 Population group 2012 2013 2014 2014 Language background other 2.1% 1.6% 1.3% 118 than English Aboriginal or Torres Strait 1.7% 0.9% 1.7% 17 Islander Areas of most disadvantage 1.3% 1.1% 1.1% 139 (IRSD 1) Areas of least disadvantage 0.6% 0.5% 0.6% 77 (IRSD 5) One-parent family 1.3% 1.4% 1.4% 106 Boys 1.1% 0.9% 0.9% 279 Girls 0.8% 0.7% 0.6% 191 Rural/Regional areas 0.8% 0.6% 0.7% 122 Metropolitan areas 0.9% 0.8% 0.8% 348 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 12 Weight Tables 5a – 5b show parent perception of their child’s weight. In 2014, 88 per cent of parents reported their child as having a healthy weight, with just over 2 per cent of parents perceiving their child to be overweight. However, the Australian Health survey (2011-2013) found that 23 per cent of 2-4 year olds were overweight or obese5. Consistent with data from 2012 to 2014, children with a language background other than English were least likely to be reported as a healthy weight, with 10.2 per cent of these children reported to be underweight. Children most likely to be reported as overweight in 2014 were children from one-parent families, where as in 2013 Aboriginal and Torres Strait Islander children were the most likely. Boys were more likely to be reported as underweight, and girls were more likely to be reported as overweight. Children from metropolitan areas were more likely to be reported as underweight, with little difference in the proportion reported to be overweight between rural/regional and metropolitan areas.

5 Australian Health Survey (ABS), 2011-2013

Department of Education and Training 13 Table 5a: Parental perception of child's weight, Victoria, 2012-2014 (Underweight) Population group 2012 2013 2014 2014 number All Children 5.4% 5.1% 5.2% 3,271 Language background other than 11.8% 10.1% 10.2% 894 English Aboriginal or Torres Strait Islander 4.9% 4.8% 5.0% 51 Areas of most disadvantage (IRSD 1) 6.5% 6.1% 5.9% 781 Areas of least disadvantage (IRSD 5) 5.0% 4.5% 4.8% 660 One-parent family 6.1% 5.5% 5.7% 434 Boys 6.5% 5.9% 6.0% 1,882 Girls 4.5% 4.5% 4.6% 1,375 Rural/Regional areas 3.8% 3.4% 3.7% 641 Metropolitan areas 6.0% 5.7% 5.7% 2,627 Note: categories will not sum to ‘all children’ due to missing or invalid data

Table 5b: Parental perception of child's weight, Victoria, 2012-2014 (Overweight) Population group 2012 2013 2014 2014 number All Children 1.8% 2.2% 2.2% 1,386 Language background other than 2.2% 2.5% 2.6% 226 English Aboriginal or Torres Strait Islander 2.5% 3.7% 2.7% 27 Areas of most disadvantage (IRSD 1) 2.4% 2.7% 2.6% 344 Areas of least disadvantage (IRSD 5) 1.3% 1.8% 1.7% 231 One-parent family 2.9% 3.2% 3.4% 261 Boys 1.5% 1.9% 2.0% 632 Girls 2.2% 2.6% 2.5% 739 Rural/Regional areas 1.8% 2.3% 2.2% 384 Metropolitan areas 1.8% 2.2% 2.2% 1,000 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 14 Asthma In 2014 one in seven Victorian children on school entry had been diagnosed with asthma. This figure has remained relatively consistent from 2012 to 2014. Of children reported to have asthma, half (51 per cent) were reported to have an Asthma Action Plan at school. Table 6 shows the percentage of children with asthma by population group. Since 2012, population groups at risk, with the exception of children from a language background other than English, have been more likely to be reported as having asthma, with Aboriginal and Torres Strait Islander children the most likely population (with approximately one in five children diagnosed). Children from rural/regional areas were more likely to be reported as having asthma compared with children in metropolitan areas. Boys were also more likely than girls to have been reported as having an asthma diagnosis.

Table 6: Children diagnosed with asthma, Victoria, 2012-2014 Population group 2012 2013 2014 2014 number All Children 14.9% 14.0% 13.8% 8,740 Language background other than English 11.6% 10.7% 10.3% 905 Aboriginal or Torres Strait Islander 20.9% 21.8% 20.6% 210 Areas of most disadvantage (IRSD 1) 15.5% 15.3% 14.6% 1,919 Areas of least disadvantage (IRSD 5) 13.4% 12.5% 12.6% 1,715 One-parent family 19.1% 18.1% 17.0% 1,293 Boys 18.3% 17.5% 17.1% 5,335 Girls 12.1% 11.3% 11.3% 3,364 Rural/Regional areas 16.1% 15.4% 15.6% 2,682 Metropolitan areas 14.5% 13.5% 13.1% 6,050 Note: categories will not sum to ‘all children’ due to missing or invalid data

Allergy Analysis of SEHQ data (2012 to 2014) indicates that over ten per cent of children in Victoria have been told by a doctor that they have an allergy by the time they reach their first year of primary school. Of the children reported to have an allergy, 30 per cent were reported to have an Allergy Action Plan at school. There is little variation in the proportion of children with an allergy across population groups. However, there was a slightly higher proportions of boys, children from metropolitan regions and children living in areas of least disadvantage (compared to areas of most disadvantage), reported to have an allergy in 2014.

Department of Education and Training 15 Table 7: Children with known allergy, Victoria, 2012 – 2014 Population group 2012 2013 2014 2014 number All Children 11.2% 10.8% 10.5% 6,632 Language background other 10.6% 10.7% 10.2% 902 Aboriginalthan English or Torres Strait 10.4% 8.6% 8.8% 90 AreasIslander of most disadvantage 10.1% 9.7% 9.3% 1,229 Areas(IRSD of1) least disadvantage 11.8% 11.5% 11.5% 1,575 One-parent(IRSD 5) family 11.3% 11.2% 10.9% 833 Boys 12.6% 12.3% 11.6% 3,616 Girls 10.2% 10.0% 10.0% 2,989 Rural/Regional areas 10.0% 9.4% 9.0% 1,558 Metropolitan areas 11.6% 11.3% 11.0% 5,071 Note: categories will not sum to ‘all children’ due to missing or invalid data

Anaphylaxis Since 2012, parents have been asked if their child has an allergic reaction that may result in anaphylaxis. In 2014, 2.2 per cent of children were reported to have a known allergy that may result in anaphylaxis. Of these children 69 per cent were reported to have an Anaphylaxis Action Plan at school. Whilst there is minimal difference between population groups, boys and children from areas of least disadvantage (IRSD quintile 5) were more likely to have a known allergy that may result in anaphylaxis.

Table 8: Children with known allergy that may result in anaphylaxis, Victoria, 2012-2014 Population group 2012 2013 2014 2014 Number All Children 2.4% 2.2% 2.2% 1,382 Language background other than 1.8% 2.2% 2.1% 184 English Aboriginal or Torres Strait Islander 1.9% 1.7% 1.9% 19 Areas of most disadvantage (IRSD 1) 1.7% 1.8% 1.7% 226 Areas of least disadvantage (IRSD 5) 3.2% 2.8% 3.0% 405 One-parent family 1.6% 1.8% 1.8% 141 Boys 2.9% 2.7% 2.7% 838 Girls 1.9% 1.8% 1.8% 537 Rural/Regional areas 2.0% 1.7% 1.6% 280 Metropolitan areas 2.5% 2.3% 2.4% 1,102 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 16 Speech and Language

Difficulties with speech and language Since 2012, approximately 14 per cent of parents (or one in seven) have reported that their child has difficulty with speech and language. Of these children, around one in four (27 per cent) reported that they were currently seeing a speech pathologist6. Population groups at risk, with the exception of children from a language background other than English, reported higher rates of difficulty with speech and language, with one in four Aboriginal or Torres Strait Islander children reported to have difficulties. The 2014 SEHQ data indicates that almost one in five boys compared with one in nine girls have a difficulty with speech and language as reported by their parents. Children living in rural/regional areas were also more likely to be reported as having a difficulty with their speech and language compared with metropolitan regions.

Table 9: Children reported to have difficulties with speech and language, by population groups, Victoria, 2012 –2014 Population group 2012 2013 2014 2014 number All Children 13.8% 13.8% 14.2% 9,016 Language background other than English 10.0% 10.0% 10.3% 908 Aboriginal or Torres Strait Islander 22.5% 20.7% 24.3% 247 Areas of most disadvantage (IRSD 1) 15.6% 15.4% 16.0% 2,103 Areas of least disadvantage (IRSD 5) 11.5% 11.8% 11.5% 1,568 One-parent family 18.0% 17.9% 18.9% 1,443 Boys 18.5% 18.5% 18.6% 5,809 Girls 9.6% 9.8% 10.6% 3,158 Rural/Regional areas 16.8% 16.5% 17.6% 3,028 Metropolitan areas 12.6% 12.8% 13.0% 5,982 Note: categories will not sum to ‘all children’ due to missing or invalid data

6 Speech and language service use is asked twice in the SEHQ; this figure does not include the proportion of children reported to have seen a speech pathologist in the past twelve months, just those children whose parents reported ‘yes’ that their child is currently seeing a speech pathologist.

Department of Education and Training 17 Types of speech and language difficulties Parents were asked to indicate different types of speech and language difficulties from a list of nine. Table 10 shows parents with one or more concerns about their child’s speech and language, including parents who didn’t indicate that they had a difficulty with their speech and language in the previous question. The most common difficulties with speech language reported by parents were related to expressive language skills.

Table 10: Types of speech and language concerns reported by parents, Victoria, 2012–2014 Type of speech and language difficulty 2012 2013 2014 2014 number Reluctant to speak 1.7% 1.7% 1.9% 1,187 Speech not clear to the family 3.4% 3.4% 3.5% 2,219 Speech not clear to others 7.9% 7.7% 7.9% 4,994 Difficulty finding words 4.9% 4.9% 5.1% 3,227 Difficulty putting words together 4.8% 4.7% 4.8% 3,022 Doesn't understand you when you speak 1.0% 1.0% 1.0% 637 Doesn't understand others when they 1.3% 1.2% 1.3% 805 speak Voice sounds unusual 1.5% 1.4% 1.5% 980 Stutters or stammers 2.6% 2.6% 2.8% 1,756 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 18 Service use

Involvement with health services The SEHQ asks parents about their child’s involvement with health services over the previous twelve months. Of the services listed, children are most likely to have visited a General Practitioner, with 79 per cent of parents reporting that their child had attended a General Practitioner in the past twelve months, as shown in Table 11.

Table 11: Children reported to have attended a health service, Victoria, 2012- 2014 Service type 2012 2013 2014 2014 number General Practitioner (GP) 79.8% 78.3% 78.9% 49,994 Hospital Emergency Department (ED) Staff 15.3% 14.5% 15.2% 9,650 Paediatrician 10.6% 10.4% 10.8% 6,842 Maternal & Child attended Health nurse 5.4% 7.1% 6.6% 4,171 Optometrist/eye doctor 17.1% 16.9% 18.1% 11,502 Child attended - Audiologist/hearing 10.5% 9.6% 10.0% 6,321 specialist Speech Pathologist/Speech Therapist 11.9% 11.6% 11.9% 7,516 Early Childhood Intervention Services (ECIS) 5.7% 6.0% 6.2% 3,962 Therapist or Practitioner Dentist (including orthodontist, periodontist 48.5% 48.0% 50.3% 31,894 etc) Complementary practitioner 4.0% 4.1% 3.7% 2,367 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 19 Maternal child health The proportion of parents reporting that their child attended a Maternal and Child Health (MCH) Service for a 3.5 year old check in 2014 was 75 per cent. Table 12 shows that some population groups were less likely to attend an MCH service, with children from a language background other than English having the lowest reported MCH attendance rate. Children living in areas of least disadvantage reported higher rates than children in areas of most disadvantage. There was no difference in attendance rates for boys and girls, but a one per cent increase in MCH participation for children from a rural area. Children from rural/regional areas attended the 3.5 year check at higher rates than children from metropolitan areas. From 2012 to 2014 there has been a large increase in attendance for one-parent families (9 per cent since 2012) and Aboriginal or Torres Strait Islander children (6 per cent increase).

Table 12: Children reported to have attended a Maternal and Child Health Centre for their 3.5 year-old check, by population groups, Victoria, 2012-2014 Population group 2012 2013 2014 2014 All Children 73.4% 74.5% 75.0% number47,540 Language background other 60.0% 62.2% 62.2% 5,478 Aboriginalthan English or Torres Strait 64.5% 68.2% 70.8% 720 AreasIslander of most disadvantage 68.8% 71.1% 70.8% 9,328 Areas(IRSD of1) least disadvantage 76.5% 76.5% 75.8% 10,356 One-parent(IRSD 5) family 65.5% 70.8% 74.4% 5,673 Boys 75.4% 76.8% 77.2% 24,124 Girls 75.0% 77.0% 77.7% 23,217 Rural/Regional areas 76.5% 78.8% 79.8% 13,745 Metropolitan areas 72.1% 72.9% 73.2% 33,761 Note: categories will not sum to ‘all children’ due to missing or invalid data

Kindergarten The SEHQ asked parents if in the twelve months prior to starting school, their child attended a preschool or kindergarten program led by a qualified (early childhood) teacher. In 2014 90 per cent of parents indicated that their child attended a preschool program. This figure differs from the official kindergarten participation rate of 98.2 per cent (2013) based on funded kindergarten enrolments as a percentage of eligible population7. Table 13 shows that parents of children in population groups at risk were less likely

7 This difference may be due to parent interpretation of the question; for example, some parents whose children attended long day care in the year preceding school may not be aware of the delivery of a preschool program within that setting for their child; also, not all children are represented in the SEHQ.

Department of Education and Training 20 to report that their child attended a preschool or kindergarten program, with the lowest proportion among Aboriginal and Torres Strait Islander children. Children in least disadvantaged areas were more likely to attend kindergarten or preschool, with slight differences between girls or boys or children from rural or metropolitan areas. Table 13: Children reported to have attended preschool or kindergarten program, by population groups, Victoria, 2012-2014 Population group 2012 2013 2014 2014 All Children 91.5% 88.7% 89.9% number56,997 Language background other 90.0% 89.4% 89.2% 7,854 Aboriginalthan English or Torres Strait 85.5% 84.3% 87.0% 885 AreasIslander of most disadvantage 88.4% 86.5% 86.7% 11,433 Areas(IRSD of1) least disadvantage 92.7% 88.8% 90.0% 12,299 One-parent(IRSD 5) family 90.4% 88.2% 89.7% 6,841 Boys 93.7% 91.5% 92.7% 28,945 Girls 93.9% 91.6% 93.0% 27,806 Rural/Regional areas 91.6% 89.1% 90.7% 15,628 Metropolitan areas 91.5% 88.5% 89.6% 41,326 Note: categories will not sum to ‘all children’ due to missing or invalid data

Vision Services In 2014, 1 in 12.5 parents reported that they were concerned about their child’s vision. Table 14 shows that of the population groups at risk, 1 in 10 parents of Aboriginal or Torres Strait Islander children reported a concern about their child’s vision. Of all parents that reported a concern about their child’s vision in 2014, 56 per cent reported that their child had seen an Optometrist/Eye Doctor in the last twelve months.

Table 14: Parents concerned about their child's eyesight, by population group, Victoria, 2012-2014 Population group 2012 2013 2014 2014 number All Children 7.8% 7.9% 8.0% 5,058 Language background other 12.9% 9.4% 9.7% 852 than English Aboriginal or Torres Strait 9.1% 9.1% 10.1% 103 Islander Areas of most disadvantage 8.7% 7.5% 7.4% 972 (IRSD 1) Areas of least disadvantage 7.3% 8.2% 8.1% 1,113 (IRSD 5) One-parent family 9.4% 9.7% 9.4% 720

Department of Education and Training 21 Population group 2012 2013 2014 2014 number

Boys 8.1% 8.3% 8.4% 2,628 Girls 7.9% 8.0% 8.0% 2,395 Rural/Regional areas 6.5% 7.1% 7.6% 1,303 Metropolitan areas 8.3% 8.2% 8.1% 3,750 Note: categories will not sum to ‘all children’ due to missing or invalid data

Oral Health Services In 2014, one in seven parents reported a concern about their child’s oral health; of these children 58 per cent reported that their child had seen a dentist in the past twelve months. Parents of children from population groups at risk were more likely to report a concern about their child’s oral health. More than one in four parents of Aboriginal or Torres Strait Islander, and one in five parents of children from language background other than English, reported that they were concerned with their child’s oral health. There was little difference between children from rural/regional and metropolitan areas and between boys and girls.

Table 15: Parent's concern about their child's oral health, Victoria, 2012-2014 Population group 2012 2013 2014 2014 All Children 14.4% 14.6% 14.5% number9,165 Language background other 19.8% 20.4% 20.0% 1,757 Aboriginalthan English or Torres Strait 21.5% 22.6% 24.2% 246 AreasIslander of most disadvantage 17.3% 17.6% 17.3% 2,277 Areas(IRSD of1) least disadvantage 11.9% 12.2% 12.3% 1,686 One-parent(IRSD 5) family 19.0% 20.3% 19.5% 1,490 Boys 15.1% 15.0% 14.9% 4,646 Girls 14.5% 15.2% 15.0% 4,475 Rural/Regional areas 14.6% 14.9% 14.7% 2,526 Metropolitan areas 14.4% 14.6% 14.4% 6,636 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 22 Just over 50 per cent of children recorded in the 2014 SEHQ cohort were reported to have seen a dentist in the past twelve months. Table 16 shows the proportion of children who have seen a dentist in the past twelve months by population group. Children from population groups at risk were less likely to have seen a dentist, the least likely being children from a language background other than English. One in three of these children were reported to have seen a dentist. There is a significant difference between areas of most and least disadvantage with children in areas of most disadvantage (IRSD quintile 1) being sixteen per cent less likely to have seen a dentist in the past twelve months. A higher proportion of children in rural regions had seen a dentist compared with metropolitan regions, and there was little difference between boys and girls.

Table 16: Proportion of children who have seen a dentist in the past 12 months, Victoria, 2012-2014 Population group 2012 2013 2014 2014 All Children 48.5% 48.0% 50.3% number31,894 Language background other 30.1% 30.4% 34.2% 3,008 Aboriginalthan English or Torres Strait 42.4% 41.1% 44.0% 448 AreasIslander of most disadvantage 39.5% 39.4% 42.3% 5,578 Areas(IRSD of1) least disadvantage 58.1% 57.6% 58.8% 8,031 One-parent(IRSD 5) family 40.8% 41.8% 44.0% 3,358 Boys 49.4% 49.3% 51.8% 16,177 Girls 50.0% 50.0% 52.1% 15,584 Rural/Regional areas 51.8% 52.8% 54.9% 9,458 Metropolitan areas 47.1% 46.2% 48.6% 22,414 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 23 General Development

Children at risk of developmental and/or behavioural problems The Parental Evaluation of Developmental Status (PEDS) is a methodology for detecting developmental and behavioural problems in children from birth to eight years of age8. This methodology involves asking parents to complete a ten item questionnaire, which has been incorporated in the SEHQ since 20079. The PEDS can be used as a developmental screening test, or an informal means to elicit and respond to parent concerns.

Table 17a: Children at risk of developmental and/or behavioural problems, Victoria, 2012-2014 - PEDS Pathway A (High risk) Population group 2012 2013 2014 2014 number All Children 13.5% 14.0% 14.7% 9,316 Language background other than 15.5% 15.9% 15.8% 1,392 English Aboriginal or Torres Strait 20.1% 20.1% 21.9% 223 Islander Areas of most disadvantage 15.2% 15.6% 15.7% 2,072 (IRSD 1) Areas of least disadvantage 12.0% 12.4% 13.1% 1,791 (IRSD 5) One-parent family 18.9% 18.5% 19.8% 1,512 Boys 17.0% 17.6% 18.4% 5,758 Girls 10.5% 11.1% 11.8% 3,519 Rural/Regional areas 13.2% 13.6% 14.5% 2,491 Metropolitan areas 13.6% 14.1% 14.8% 6,821

Note: categories will not sum to ‘all children’ due to missing or invalid data

8 Further information on PEDS available from http://www.rch.org.au/ccch/resources.cfm?doc_id=10963

9 Unlike classic administration of PEDS, the completion of the SEHQ by parents is unassisted. This should be considered when interpreting these results.

Department of Education and Training 24 Table 17b: Children at risk of developmental and/or behavioural problems, Victoria, 2012-2014 - PEDS Pathway B (Moderate risk)

Population group 2012 2013 2014 2014 number All Children 25.3% 26.3% 27.1% 17,184 Language background other 25.6% 27.5% 27.8% 2,446 than English Aboriginal or Torres Strait 26.1% 26.5% 27.6% 281 Islander Areas of most disadvantage 25.5% 26.1% 26.7% 3,525 (IRSD 1) Areas of least disadvantage 24.8% 26.2% 26.6% 3,639 (IRSD 5) One-parent family 25.6% 28.1% 28.3% 2,155 Boys 27.5% 28.1% 28.7% 8,977 Girls 24.2% 26.2% 27.2% 8,120 Rural/Regional areas 25.3% 25.7% 27.2% 4,686 Metropolitan areas 25.3% 26.5% 27.1% 12,489

Note: categories will not sum to ‘all children’ due to missing or invalid data

Children at high risk Children with two or more significant concerns are considered to be at high risk of developmental and/or behavioural problems, or PEDS Pathway A. Tables 17a – 17b show that in 2014 one in seven children were at high risk of developmental and behavioural problems according to the PEDS. Children from at risk population groups were more likely be categorised as PEDS Pathway A, the most significant being Aboriginal or Torres Strait Islander children with one-in-four at high risk. Boys were also more likely to be categorised as high risk, with minimal difference between children from rural/regional and metropolitan areas.

Children at moderate risk Children with one significant concern are considered to be at moderate risk of developmental and/or behavioural problems, or PEDS Pathway B. In 2014, approximately one in four children were categorised as PEDS Pathway B, with minimal difference between population groups. There was, however, a slight difference in the proportion of boys compared with girls with 1.9 per cent more boys at a moderate risk of developmental and/or behavioural problems.

Department of Education and Training 25 Behavioural and emotional wellbeing

Behavioural and emotional wellbeing The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening questionnaire for 4-17 year olds developed in the United Kingdom10. The SDQ has been amended for use in Australia and exists in several versions that can be completed by children, adolescents, parents and teachers. All versions of the SDQ include questions on 25 psychological attributes which are divided between five scales: emotional symptoms; conduct problems; hyperactivity; peer problems; and prosocial. Tables 18a – 18b shows the proportion of children at high and moderate risk of clinically significant problems related to behaviour as determined by their total difficulties score. Table 18a: Children at risk of significant clinical problems related to behaviour and emotional wellbeing, Victoria, 2012-2014 (High risk) Population Group 2012 2013 2014 2014 All Children 4.3% 4.4% 4.6% number2,888 Language background other 4.1% 3.7% 3.8% 338 Aboriginalthan English or Torres Strait 12.7% 11.9% 12.4% 126 AreasIslander of most disadvantage 5.8% 6.2% 6.4% 843 Areas(IRSD of1) least disadvantage 2.6% 2.4% 2.6% 358 One-parent(IRSD 5) family 8.7% 9.5% 9.9% 756 Boys 5.8% 5.7% 5.9% 1,829 Girls 3.0% 3.2% 3.5% 1,045 Rural/Regional areas 5.5% 5.7% 6.3% 1,091 Metropolitan areas 3.9% 3.8% 3.9% 1,796 Note: categories will not sum to ‘all children’ due to missing or invalid data Table 18b: Children at risk of significant clinical problems related to behaviour and emotional wellbeing, Victoria, 2012-2014 (Moderate risk) Population Group 2012 2013 2014 2014 All Children 4.4% 4.5% 4.4% number2,793 Language background other 5.0% 5.5% 5.4% 477 Aboriginalthan English or Torres Strait 10.1% 7.7% 9.5% 97 AreasIslander of most disadvantage 5.9% 5.6% 5.5% 719 Areas(IRSD of1) least disadvantage 3.0% 3.0% 3.2% 441 One-parent(IRSD 5) family 8.0% 7.8% 7.5% 570 Boys 5.5% 5.5% 5.3% 1,656 Girls 3.5% 3.7% 3.8% 1,124 Rural/Regional areas 5.1% 4.8% 4.7% 815

10 Goodman, R (1997) The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry, 38, 581-586

Department of Education and Training 26 Population Group 2012 2013 2014 2014 Metropolitan areas 4.1% 4.4% 4.3% number1,976 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 27 Children at high risk Children identified with an abnormal SDQ are considered at a high risk of clinically significant problems related to behaviour. The 2014 SEHQ count indicates that 1 in 22 children were identified at high risk, with children from at risk populations (with the exception of children from a language background other than English) more likely to be at high risk. Aboriginal or Torres Strait Islander children are represented at more than twice the rate of the general population, with one in eight at high risk. Children in areas of most disadvantage were 2.5 times more likely to be at high risk compared to children from areas of least disadvantage. Boys and children from rural/regional areas were also more likely to be at high risk as determined by their total difficulties score.

Children at moderate risk Children identified with a borderline SDQ are considered at moderate risk of clinically significant problems related to behaviour. The 2014 SEHQ count indicates that children from population groups at risk are more likely to be categorised at moderate risk of clinically significant problems related to behaviour, with Aboriginal or Torres Strait Islander children represented at more than twice the general rate. Boys are more likely to be at moderate risk of behavioural problems than girls, with little difference between children from rural/regional and metropolitan areas.

Proportion of children at risk across SDQ sub-scales Table 19 shows the proportion of children that scored at either high or moderate risk of clinically significant problems across each of the five sub scales of the SDQ. The 2014 SEHQ data indicates that the largest proportion of children were at high or moderate risk on the peer problem or conduct problem scales.

Table 19: Proportion of children at high/moderate risk of clinically significant problems across SDQ sub scales, Victoria, 2012-2014 SDQ sub scales 2012 2013 2014 2014 number Conduct Problems 14.6% 14.5% 14.5% 9,175 Emotional 10.5% 10.8% 10.8% 6,842 Symptoms Hyperactivity 11.5% 11.4% 11.6% 7,368 Peer Problems 16.4% 16.1% 16.2% 10,284 Prosocial 8.9% 8.5% 8.3% 5,289

Department of Education and Training 28 Family issues and stressors The SEHQ asks parents to rate their family’s level of stress over the month prior to completing the questionnaire using a five point Likert scale, from ‘almost more than I can bear’ to ‘little or no stress/pressure’.

Stress Levels Reporting of stress by parents has decreased slightly from 2012 to 2014.This can be seen in Tables 20a – 20c, which outline the proportion of families reporting highest stress, high stress and high/highest stress combined. In 2014, one in nine parents reported high or highest stress in their family, with one- parent families and families with Aboriginal or Torres Strait Islander children more likely to report high or highest stress; one in five and one in six respectively. Families in rural/regional areas were more likely to report high or highest stress than metropolitan families. Families with children from a language background other than English were less likely to report high stress, with one in fourteen parents reporting high or highest stress. There is little difference between other population groups.

Table 20a: Families reporting high stress by population groups, Victoria, 2012- 2014 Population Group 2012 2013 2014 All Children 9.9% 9.7% 9.5% Language background other than English 5.8% 6.0% 5.3% Aboriginal or Torres Strait Islander 13.9% 13.8% 12.6% Areas of most disadvantage (IRSD 1) 9..1% 8.8% 8.3% Areas of least disadvantage (IRSD 5) 9.6% 9.6% 10.1% One-parent family 15.6% 15.4% 15.7% Boys 10.3% 10.1% 10.1% Girls 10.0% 9.9% 9.5% Rural/Regional areas 10.9% 10.6% 10.5% Metropolitan areas 9.5% 9.3% 9.1% Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 29 Table 20b: Families reporting highest stress by population groups, Victoria, 2012-2014 Population Group 2012 2013 2014 All Children 1.5% 1.5% 1.5% Language background other than English 1.3% 1.5% 1.7% Aboriginal or Torres Strait Islander 3.3% 3.0% 4.3% Areas of most disadvantage (IRSD 1) 1.9% 1.9% 1.9% Areas of least disadvantage (IRSD 5) 1.1% 1.2% 1.0% One-parent family 4.3% 4.5% 4.1% Boys 1.6% 1.6% 1.6% Girls 1.6% 1.5% 1.5% Rural/Regional areas 1.7% 1.7% 1.7% Metropolitan areas 1.4% 1.5% 1.4% Note: categories will not sum to ‘all children’ due to missing or invalid data

Table 20c: Families reporting high/highest stress combined by population groups, Victoria, 2012-2014 Population Group 2012 2013 2014 2014 number All Children 11.4% 11.2% 11.0% 6,955 Language background other than 7.1% 7.5% 7.1% 622 English Aboriginal or Torres Strait 17.2% 16.8% 16.9% 172 Islander Areas of most disadvantage 11.0% 10.8% 10.2% 1,347 (IRSD 1) Areas of least disadvantage 10.7% 10.8% 11.1% 1,520 (IRSD 5) One-parent family 19.9% 19.9% 19.7% 1,504 Boys 11.9% 11.7% 11.7% 3,654 Girls 11.5% 11.4% 11.0% 3,276 Rural/Regional areas 12.6% 12.3% 12.3% 2,112 Metropolitan areas 11.0% 10.8% 10.5% 4,840 Note: categories will not sum to ‘all children’ due to missing or invalid data

Department of Education and Training 30 Stressors The SEHQ asks parents if their child has been affected by the following events and the degree to which they have been affected. These are categorised as ‘not at all’, ‘a lot’, ‘a little’ or ‘not applicable’. Table 21 shows the proportion of children reported to have been affected by following events, either ‘a little’ or ‘a lot’, by population group. Of all events listed, children were most likely to have been affected by moving to a new house or by the death of a friend or relative. Across the nominated events, children from rural/regional areas are more affected compared with metropolitan areas. There is little difference between, boys and girls. Divorce/separation of parents affected one in 2.5 children in one-parent families, in the previous twelve months. Moving to a new house affected one in four children in one-parent families. A new baby in the home affected Aboriginal or Torres Strait Islander children the most (one in eight compared to one in thirteen for the general population).

Table 21: Proportion of children affected by stressful events during twelve months prior to SEHQ completion, Victoria, 2014

Deat Divo Mov New Pare Pare Rem Seri Serio h of rce/s e to baby nt nt arria ous us Population relati epar new in chan loss ge of illne illne Group ve/ ation hous hom ge of of pare ss of ss of frien of e e job job nt pare sibli d pare nt ng nts

All Children 11.3 7.2% 13.8% 7.8% 11.4% 4.1% 1.1% 4.1% 1.9% %

Language 4.7% 4.0% 14.8% 9.6% 7.5% 4.1% 0.5% 2.5% 1.2% background other than English

Aboriginal or 16.9% 19.7% 22.0% 12.0% 10.4% 5.2% 2.8% 8.9% 4.4% Torres Strait Islander

Areas of 10.5% 9.3% 13.5% 8.9% 10.1% 4.2% 1.2% 4.5% 2.0% most disadvantage (IRSD 1)

Areas of 10.9% 4.8% 14.3% 6.1% 11.6% 3.7% 0.8% 3.5% 1.4% most disadvantage (IRSD 5)

One-parent 13.7% 9.9% 27.3% 6.9% 13.1% 5.8% 3.9% 7.7% 2.6% family

Boys 11.1% 7.5% 14.2% 7.9% 11.7% 4.2% 1.1% 4.2% 1.9%

Girls 12.2% 7.4% 14.3% 8.1% 11.8% 4.3% 1.0% 4.2% 2.0%

Department of Education and Training 31 Deat Divo Mov New Pare Pare Rem Seri Serio h of rce/s e to baby nt nt arria ous us Population relati epar new in chan loss ge of illne illne Group ve/ ation hous hom ge of of pare ss of ss of frien of e e job job nt pare sibli d pare nt ng nts

Rural/Region 14.2% 9.0% 15.5% 8.3% 13.3% 4.1% 1.4% 5.3% 2.4% al areas

Metropolitan 10.2% 6.5% 13.1% 7.6% 10.6% 4.0% 0.9% 3.7% 1.7% areas

The SEHQ also asked parents to indicate if there is a family history of specific issues, which are outlined in Table 22. Of all issues listed, parental mental illness is the most common issue to be reported, with one in fourteen families experiencing a history of parental mental illness. Population groups at risk, with the exception of children from a language background other than English, are more likely to report a family history of one or more of the issues listed. One-parent families and families with Aboriginal or Torres Strait Islander children are approximately four times more likely to report a history of abuse to a parent, history of drug related problems, and a history of parent witnessing violence compared with the general population. They are five times as likely to report a history of a child witnessing violence.

Department of Education and Training 32 Table 22: Proportion of children with reported family issues, Victoria, 2014

History History History History History History History of abuse of of of child of of of Population to child abuse alcohol witnessi alcohol mental parent Group to or drug ng or drug illness witnessi parent related violence related of ng problem problem parent violence s in s in family family

All Children 1.2% 3.3% 3.6% 3.1% 1.0% 6.9% 3.1%

Language 0.9% 1.7% 1.1% 1.9% 0.9% 1.4% 2.0% background other than English

Aboriginal or 4.2% 12.5% 14.6% 14.8% 2.6% 14.4% 11.6% Torres Strait Islander

Areas of most 1.6% 4.2% 4.5% 4.4% 1.2% 7.2% 4.1% disadvantage (IRSD 1)

Areas of most 0.8% 2.1% 2.2% 1.7% 0.9% 5.6% 2.0% disadvantage (IRSD 5)

One-parent family 4.5% 15.0% 13.5% 14.2% 3.1% 17.1% 11.5%

Boys 1.3% 3.4% 3.8% 3.2% 1.0% 7.1% 3.2%

Girls 1.2% 3.3% 3.7% 3.2% 1.1% 7.1% 3.1%

Rural/Regional 1.7% 4.4% 5.1% 4.3% 1.1% 9.8% 3.9% areas

Metropolitan 1.0% 2.8% 3.1% 2.7% 1.0% 5.8% 2.7% areas

Department of Education and Training 33