Concerns about CDS services and equitable access for regional children

Wednesday 26th October, 2022 To the select committee members

The Hon Dr Sally Talbot MLC

The Hon Donna Faragher MLC

The Hon Samantha Rowe MLC

Thank you for your invitation to make a submission to the Inquiry into Child Development Services (CDS). As you may be aware, I was the principal petitioner in relation to supporting the inquiry after receiving a letter from Hon Donna Faragher in my capacity as Community Kindergartens President WA. I was keen to show the parliament how necessary an inquiry is to see important action taken in this space. I would like to acknowledge the 3,751 Western Australians who took the call for action over a three-week period, and signed the petition. Their voices are now able to be heard by this committee. After hearing numerous personal accounts, I can attest many people will have great ideas, as well as great frustrations

The positive impact  that CDS  specialists can have on a  child’s  overall

development health and wellbeing is of paramount importance, particularly for children who have developmental, physical or neurological challenges. It is imperative that West Australian children have expedited access to these crucial services, and that these services are sufficiently staffed to meet the ever growing demands of the burgeoning population. Through liaison with Community Kindergarten educators, parents and the Department of Education in my role as president, I have learned that the rate of referral in kindergarten for the CDS and wait times for services (e.g. speech pathology, OT, audiology) has increased each year since 2019. One such example was at one of our community kindergartens, out of two groups of kindergarten children, totalling 40 enrolments, 25 referrals for CDS speech pathology were made by the teacher due to concerns about their oral language development and their readiness for Pre-primary. On Thursday October 20th, I attended the Early Years Partnership forum in Katanning in which several key local issues came up that I believe provide vital evidence for the justification of this inquiry. These issues included the high cost of childcare, limited access to services (logistically and socially), language and communication barriers, and family domestic violence, in regional areas. During the forum we learned that the three-year-old check-up appointment was being removed from the Child Health Nurse schedule, possibly due to there being no scheduled immunisation at this age. However, for developmental reasons, this check is critical as it is an opportunity for parents and carers to discuss concerns with the Child Health Nurse, and grant permission for a CDS referral to be made. With the removal of this crucial appointment, children are now less likely to receive intervention

and assistance before entering kindergarten. Another issue  is the  cultural and

language barriers that many families face, with information on the key developmental milestones for children often being lost in translation or done in a culturally insensitive manner. The CDS must play a bigger role in educating families and the broader community on the importance of supporting children to meet these milestones and what to do it they are not.

Children may be recognised at need of early intervention if they attend an early learning centre, and the staff are able to recognise any developmental problems and engage support services or inform the parents. However, it could be viewed that it is

a huge task to add to staff workload, who may not be specifically trained in this area, unlike a child health nurse. An option here could be that child health nurses, both metro and regional are allocated some time to visit or are employed specifically to visit all childcare centres (private, NFP, community run and family childcare) This in the interim, could support a lot of parents/carers and early learning staff to ensure children are not slipping through the cracks – this of course would have to be subject to parental/carer consent . Another point arising from Thursday’s forum was the acceptance of substandard, for want of a better term, appropriate developmental achievements or milestones for children. This is caused by many factors – but educating and explaining in a culturally respectful way to families why health practitioners look for certain achievements of children at certain ages is crucial. Thursday’s forum was problem focused, the next to

be scheduled section  is solutions focused, and  I’d recommend that perhaps on

invitation, or request (I am aware that several stakeholders were making submissions) attend the next Katanning forum (as we are slightly further ahead of the other 3 EYP sites.

On speaking to the head of South Metropolitan Education Regional Office CDS recently I enquired as to what the contact between Metropolitan CDS and West Australian County Health Service is. I was informed that it was only at an information level handover, should a child move boundaries. This relationship (particularly on metro/regional borders) could certainly be looked at and better developed. WACHS is not as organised in relation to CDS as MCDS, so this also needs to be looked at. This was evident in the collection of data tabled in parliament on wait times. Developmental and medical paediatrics are not separated, and need to be for more accurate data collection to address which paediatric wait times are longer or in more demand from referral. Through my own enquiries, I have learned that there are 2 trained speech pathologists at Katanning Health Campus on ‘other duties’ as there is ’no funding ’ for speech

pathology.  I certainly hope that this isn’t the case.  I believe this inquiry has the

opportunity to investigate this to determine how the needs to the wider Katanning community could be better served. An example of a Katanning family impacted by this is one where the 6 years old son is on the NDIS, excluding him from accessing WACHS support services. However, as we are a smaller regional town, this boy can

only  access  infrequent  expensive  speech  pathology  privately  at  $400 per

session. Access to a well-resourced CDS in a regional town would give more equitable access to children across our state, to have their needs met and have the same opportunities as children in metropolitan areas.

Once a child is registered on NDIS, I have been informed that you can’t see WACHS staff, in relation to therapy (you can remail seeing your initial public paediatrician). However, no NDIS, no funding at all for your child’s therapy. Following the federal

NDIS review  will be extremely  important  to the  inquiry and perhaps making

submissions about how public therapy can be invoiced for NDIS patrons where private service provision is spasmodic and extremely expensive (regional WA) It is critical to ensure that equitable funding is available for the required therapy in metro and regional CDS, based on the number of children on the list for each of the services, and that they receive full treatment and are not pushed out quickly to make

way for the next child, (This concern was bought to my attention by a member of the public.

During the petition time frame, multiple concerns were brought to my attention by the numerous parents and teachers who reached out to me. Although each concern was entirely valid, I will outline the ones which resonated with me as critical:

WACHS wait times – Audiology wait times in the Great southern are quite high. I met with our project co-ordinator for the Early Years Partnership and a Health Department worker. They provided me with details on a very successful and quick audiology program developed by Donna Woithe here in Katanning. I have been informed surgery can be as soon as the next day, following an appointment. From my understanding, if places are available, children will travel from Albany to be seen in Katanning. As we look regionally, we need to try to break down some of the statistics to find where the actual locations are for extended wait times for each allied health service therapy.

Hospital wait times for procedures directly impact child development - I received an email from a kindergarten teacher regarding a student as follows:

Hi Joanne

I currently have a Kindy student who has a lazy eye. She wears glasses and is on a 2 year wait list for eye surgery at PCH. he is already showing issues with visual processing of course and will have to start again after the surgery. Her parents don’t know what else to do to get her the surgery she needs.

This child is at educational risk. She is already struggling with visual processing, and her teacher predicts she will be at a Kindergarten level by the time she enters Year 1. This will not be the only example of this issue.

Interstate Paediatric assessments, diagnosis and prescriptions not being recognised in WA - I had contact from a teacher who has moved from Queensland to Mandurah. Her son was diagnosed in his home state, had a medical plan including medication and as it is not recognised here, he is on a 3 year wait list to be re-assessed and is now going backward both academically and behaviourally. This is negatively impacting the entire family unit. It would greatly beneficial to WA families if medical professionals are recognised Australia wide, including prescribing clinicians. A positive result from this inquiry would be the establishment of a paediatric handover pathway from state to state – or the ability for video conferencing.

Curriculum content and school start age – I have made arrangements to speak with Rose Smith at SCARSA in November about the kindy curriculum guidelines and understand the differences between the guideline and then the compulsory Pre primary content. I have also, in my role with Community kindergartens seen the need to look at the legislative school start age of 5 years before June 30th the year of pre primary. Certainly, some flexibility here, or extra time in kindergarten, could certainly contribute to reducing the rate of referral for some allied health services.

In conclusion, I am certainly no expert in this area but have been contacted by families and professionals and felt that the inquiry was crucial to improving developmental, education, emotional, physical and mental well being of our state’s children now and into the future.

Thank you for taking the time to read my submission and I hope to meet with the committee during the proceedings to discuss these things further.

Kind regards,

Joanne Matthewson

Community Kindergarten Association WA President

Pineview Community Kindergarten Inc President

President@communitykindys.org.au

The ‘here and now’ for little kids and families in the Central Great Southern, 2022:

Situational analysis to inform local plans for the

Early Years Initiative in the Central Great Southern

Table of Contents

• 1. Introduction
• 2. Comments on interpretation of the data
• 3. Central Great Southern - overall
• 4. Broomehill-Tambellup
• 5. Gnowangerup
• 6. Katanning
• 7. Kojonup
• 8. Notes on research evidence about quantitative data

1. Introduction The regional community of Central Great Southern, comprising the four local government authorities (LGAs) of Broomehill-Tambellup, Gnowangerup, Katanning and Kojonup, was the first community to accept an invitation from the Western Australian State Government and the Minderoo Foundation to participate in the Early Years Initiative (EYI). The Central Great Southern is one of only four communities invited to participate in the EYI; the other three are Bidyadanga, Derby and a part of Armadale in Perth.

The ten-year EYI will run until 2028, and aims to co-design more effective ways to nurture the health, development and learning of children from conception to four years of age and to create lasting change.

The EYI is focused on very young children because the first 2000-days of life from conception to four years of age are vital in shaping each child’s long-term health, learning, social and language skills, culture and identity. A solid start in this period before they start school lays the ground-work for children to become strong, proud grown-ups who have a good life.

While the EYI is focused on improving outcomes in early childhood, it recognises that children are raised by families who live within dynamic communities so it is intended that actions taken through the EYI will be holistic, culturally responsive and strengths-based. It is anticipated that through the EYI in coming years, insights will emerge about how the State Government and other organisations can better support families and young children in the four EYI partner communities, and that these insights can be applied at scale to other places in the future.

A key premise of the EYI is that people living and working in the four partner communities are best placed to understand local needs and strengths, and to decide what actions are most likely to work in the unique context of their community. To facilitate these decisions, Telethon Kids Institute – the EYI’s Evidence Partner – has prepared this Situational Analysis Report for the Central Great Southern. It contains key data to outline the ‘here and now’ of children and families in this community with respect to key indicators which, according to research evidence, have a large impact on children’s long-term health, development and learning and warrant close attention.

Four LGAs make up the EYI’s Central Great Southern community so the data in this report are presented for each separate LGA (i.e.: Broomehill-Tambellup, Gnowangerup, Katanning and Kojonup) as well as for the Central Great Southern as a whole. In each case, the data are provided in two formats:

• ‘Snapshots’ which capture the ‘big ticket’ data items on one page
• Data tables which include comparisons at each line-item with the Western Australian average.

1

2. Comments on interpretation of the data In the Snapshots and tables, the following abbreviations have been used:

• CGS – Central Great Southern

• BT – Broomehill-Tambellup

• Gn – Gnowangerup

• Ka – Katanning

• Ko – Kojonup

• Albany SA3 – Albany Statistical Area Level 3 (where data are not available at LGA level) Australian Bureau of Statistics’ Census of Population and Housing data

• All Census data provided are for the 2016 Census, as results from the 2021 Census have not yet been published. Thus the figures in this report do not necessarily reflect major changes that the community may have undergone since 2016.

Australian Early Developmental Census (AEDC) data

• AEDC for Broomehill-Tambellup are 2015 figures – 2018 and 2021 figures are not published due to small counts. 2021 AEDC reported for overall Central Great Southern exclude Broomehill-Tambellup for this reason.

• AEDC for Broomehill-Tambellup and Gnowangerup must be interpreted with care as the number of five-year-olds at each collection in these LGAs is less than 20. This means large percentage changes are to be expected between AEDC collections due to random chance. For example, the percentage of children on track on all five domains in Gnowangerup shows considerable fluctuation - 41.4% in 2009, 78.6% in 2012, 31.6% in 2018 and 70.6% in 2021 (2015 results not published).

National Assessment Program for Literacy and Numeracy (NAPLAN) data

• NAPLAN results reporting the percentage of children who achieved at or above National Minimum Standards (NMS) were obtained from the Western Australian Department of Education website and are available only for Government schools. NAPLAN results for non-government schools are not routinely published and harder to access.

• Results are not published for some government schools where counts are small. For Broomehill-Tambellup, 2019 results are reported. For Gnowangerup, results are only for Gnowangerup District High School. For Katanning, results are for Katanning Primary School and Braeside Primary School only. For Kojonup results are for Kojonup District High School only.

• NAPLAN results must be interpreted with care as the number of Year 3 cohort each year is less than 30 children for all four LGAs.

School Attendance

• Attendance levels (the percentage of students from Year 1 to Year 10 who attended at least 90% of the time) are presented for both 2019 and 2021, as it appears that attendance levels for some schools were adversely affected by COVID-19 in 2021.

2

Socio-economic Index for Areas - Relative Socio-economic Disadvantage (SEIFA IRSD) data

• SIEFA-IRSD data are published by LGA. As the IRSD is an index, rather than a percentage, it cannot be aggregated to overall Central Great Southern. Rankings are from worst performing to best (i.e., a lower rank means greater levels of disadvantage in a region).

Child and Maternal Health data

• Child and maternal health figures were largely sourced from the Western Australian Child Development Atlas (CDA) and averaged over the four LGAs within the Central Great Southern. Counts of one to four inclusive are suppressed within the CDA. Where small counts have been suppressed but the total population was reported, lower and upper thresholds have been calculated by assuming the minimum (i.e., one) and maximum (i.e., four) values respectively.

3

CENTRAL GREAT SOUTHERN

DATA SNAPSHOT

CHILDREN

®

Births per year to

Nemper of Central Great Southem

children vecilemhe aged 0-4 FY 10.9% 8.1% 604 of children of children 04 if

Sourcer ABS (2016 Aboriginal CALD serene

Sources MBS (201d) Source: ABS (2014)

ria Family make-up Hoe ma 39.7% with children h 13.5% one parent 788 ¥ ¥ Families with children under 15 = an 45.2% neo children 1.8% other

Soc AMS NG Te Source: ABS (2014)

MATERNAL HEALTH

74% F&F & 8.9% 7.8%

of women drank alcohol of women used drugs during pregnancy during pregnancy

of women smoked

during pregnancy (WA average 7.9%)

Source: COA (2018) Source: Sork Perinatal atabose (2017) Source: Stork Perinatal Dotabone (2019)

6.0% - 7.0%

of births were to

10.4%

of births were to women aged 15-19

mothers with a mental illness (wa average 7.4%)

(WA average 10.2%)

Source: COA (2018) Source: COM (2018)

_£) 7.8%

of babies had low birth weight (=2,500g) (WA average 6.5%)

Source: CDA (2018)

Aabe! ; Evidence Partner

‘i L i TELETHON

‘GOVERNMENT OF

WESTERN SUSTRALIA

INSTITUTE

COMMUNITY

TOTAL POPULATION

8,495

Vaccination rates 89.5% of Albany SA3

Sourcec WBS (2016)

children ore fully immunised at? years old Index of relative (WA average 91.4%) socio-economic Source: CDA (2018) disdvantage

HOSPITALISATION RATES FOR 0-4 YEAR OLDS

Oral Disease related

1.4-2.6

per 100 persons. (WA average 0.8)

Source: CDA (2018)

60

Respiratory Disease related

1.2-1.5

per 100 persons (WA average 0.8)

Source: CDA (2014)

Chronic Physical Illness

&

Varies from 906 to 999

which go from the lowest to the sixth decile

Source: ABS (2014)

DIVERSITY

5.8-6.3

per 100 persons (WA average 4.3)

Source: CDA [2014

Ene

Emergency Dept

presentations 138.6 7.5% (Whaversoe 70.7) of residents are

Aboriginal

Source: ABS (3014)

FAMILY AND DOMESTIC VIOLENCE

Reported FDV i*

Incidents in *

J Katanning i . 2014-2020 .

Sources Katanning Police ‘est

© ae

of residents are

CALD

Year Source: ABS (20d)

3. Central Great Southern - overall Item Location Location Value WA Average Comments

Children

% children 0-4 in sole parent

family                       CGS               17.1%         12.8%     See note 1

% children 0-4 who don’t speak

English well or not at all          CGS                8.1%          9.0%

Family make-up See note 2

Couple family with children      CGS               39.7%         45.3%

Couple family no children       CGS               45.2%         38.5%

One parent family             CGS               13.5%         14.5%

Other family                 CGS                1.8%          1.7%

Child Health

Child health figures and hospitalisation rates below have been sourced from the WA Child Development Atlas and averaged over all four LGAs within the CGS. Where small counts have been suppressed for some LGAs, ranges have been provided based on minimum and maximum values for those LGAs.

% babies with low birth weight    CGS                7.3 - 7.9%        6.5%

% babies born pre-term          CGS                8.1%          8.6%

Albany

% fully immunised at 2 years old   SA3               89.5%         91.4%

0-4 yr old hospitalisations rates (per 100 children aged 0-4 yrs)

Ear and hearing              CGS                 2.2 - 2.5           1.9      Hospitalisation rates

are the number of  Respiratory disease            CGS                 1.2 - 1.6           0.8

hospitalisations per

Vaccine preventable diseases    CGS                 0.0 - 0.3           0.2                                                                             100 children in the

Injury                      CGS                 0.7 - 2.9           2.3     community

Maternal Health

Maternal health figures below have been sourced from the WA Child Development Atlas and averaged over all four LGAs within the CGS. Where small counts have been suppressed for some LGAs, ranges have been provided based on minimum and maximum values for those LGAs.

% births to women aged 15-19     CGS                6.0 - 7.0%        2.6%     See note 3

% women who smoked at any

time during pregnancy           CGS               17.4%          7.9%     See note 4

5

Item Location Location Value WA Average Comments

Children’s Education

2021 AEDC results for CGS exclude the Shire of Australian Early Development Broomehill-Tambellup as results for this Shire were

Census (AEDC) 2021                         not published due to small counts         See note 5

% children on track on all five

domains                    CGS               54.0%         57.9%      For CGS (excluding

% children vulnerable on one or Broomehill

more domains               CGS               27.0%         19.4%         Tambellup)

% children vulnerable on two or N=100

more domains               CGS               16.0%          9.4%

% students who attend school See note 6 more than 90% of time (Yr 1-10) 2021 attendance

2019     CGS              57 – 92%        NA      levels may have

been adversely affected by

2021     CGS              33 - 92%        NA    COVID-19

Year 3 NAPLAN results, 2021 % achieving Reading

benchmark                  CGS              95%         96.0%

% achieving Numeracy

benchmark                  CGS              91%         95.3%     See note 7

% homes with internet access     CGS               73.5%         85.1%

Figures below include people who speak English and another language plus Language people who only speak another language at home % people who speak a language

other than English at home       CGS               23.2%         19.4%

Family functioning Income See note 8 Time Measures for these vital resources and risks are not easy to find in publicly available data, but they areHuman capital included in the proposed survey of parent-caregivers Psychological capital for the EYI Evaluation Social capital

6

Item Location Location Value WA Average Comments

Community

Below figures don’t add up to 100% due to Highest level of school completed not stated and rounding See note 9

%<Yr10 CGS 13.8% 7.5%

% Yr 10 CGS 24.2% 20.2%

% Yr 11 CGS 9.5% 9.2%

% Yr 12 CGS 37.1% 53.5%

Post-school qualifications See note 9 % Certificate/Diploma CGS 24.4% 29.3% % Bachelors degree or higher CGS 9.7% 20.5%

% With a post-school qualification CGS 51.0% 61.1%

Socio-economic index CGS See note 10

SEIFA IRSD Score CGS 906-999 NA

Economy

Workforce Participation

% work Full Time CGS 62.1% 57.0% See note 11 % work Part Time CGS 26.4% 30.0% % unemployed CGS 4.9% 7.8% % temporarily away from work CGS 6.6% 5.2% Parental employment See note 11 % children 0-4 with at least one parent employed CGS 72.0% 85.7% % children 0-4 with no parent employed CGS 15.9% 14.3% Income See note 11 % family households with income less than $500 per week CGS 6.9% 4.9% % family households with income $500 to less than $1,000 per week CGS 21.5% 15.5% % family households with income $3,000 or more per

week CGS 12.8% 21.7% 7

TELETHON

KIDS telethonkids.org.au

————

Evidence Partner

BROOMEHILL-TAMBELLUP LOCAL GOVERNMENT AREA a

TELETHON

DATA SNAPSHOT covERNeNt oF ene

WESTERN AUSTRALIA

CHILDREN COMMUNITY

Births per year to 6 Number of per ye TOTAL POPULATION . Broomehill-Tambellup children residents 1144 . . rf aged 0-4 1 2 1 0 2 ROK Babies with Vaccination rates Source: ABS (2014) 107 cau fe) 10. 0 8 low birth weight (<2,500g) 89.5% of Albany 5A3 S Oso ° Oto 1.3% - 5.4% children are fully immunised uae Aboriginal CAD Source: ABS (2014) (WA average 6.5%) at 2 years old Index of relative Source: CDA (2018) (WA average 91 4%) socio-economic Source: AE (01 8) Source: ABS (201g) SETS RE HEL] disdvantage

mia Family make-up 6) & G08

os 40.6% with children i) 15.2% one parent . . . 1 1 y) ne, ft Ear and hearing related Chronic Physical Illness Broomehill-Tambellu p= Families with children under 15 2 - 42.8% no children 1.4% other ] 6 5 5 950 Source: ABS (2014) f Source: ABS (2014) per 100 persons per 100 persons which is in the (WA average 1.9) (WA average 4.3) third decile

aauatient iy

DIVERSITY

i) =A i) S Respiratory related Emergency Dept © 1 6 presentations Women who smoked . oes cee Women who drank alcohol Women who used drugs per 100 persons 6 ] 35 ] ] A% during pregnancy during pregnancy * (WA average 0.8) per 100 persons Numbers too small to report (WAa 70.7) of residents ore Numbers too small to report Numbers too small to report Souroee COA (EUG gee. Aboriginal (WA overage 7.9%) aso

ay Source: Stork pie Database Source: Stork oe) Database FAMILY AND DOMESTIC VIOLENCE

Births to Births to Reported FDV Numbers unavailable for women aged 15-19 mothers with a mental illness Incidents Broomehill-Tambellup 0 2016-2020 3 . / No 1.3% - 5.4% Numbers too small to report . of residents are (WA average 27.6%] (wa average 10.2%) CALD

Source: COA (2018) Source: CLV (2018) Sources ABE (2014

4. Broomehill-Tambellup Item Location Location Value WA Average Comments

Children

% children 0-4 in sole parent family   BT                18.8%          12.8%     See note 1

% children 0-4 who don’t speak

English well or not at all            BT                 2.8%           9.0%

Family make-up See note 2

Couple family with children        BT                40.6%          45.3%

Couple family no children         BT                42.8%          38.5%

One parent family               BT                15.2%          14.5%

Other family                   BT                 1.4%           1.7%

Child Health

Child health figures and hospitalisation rates below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% babies with low birth weight      BT                 1.3 - 5.4%         6.5%

% babies born pre-term            BT                 9.3%           8.6%

% fully immunised at 2 years old      Albany SA3         89.5%          91.4%

0-4 yr old hospitalisations rates (per 100 children aged 0-4 yrs)

Ear and hearing                 BT                      1.6              1.9

Hospitalisation rates are the  Respiratory disease              BT                      1.6              0.8

number of hospitalisations

Vaccine preventable diseases      BT                   0.0 - 0.2            0.2     per 100 children in the

Injury                         BT                   1.1 - 4.5            2.3     community

Maternal Health

Maternal health figures below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% births to women aged 15-19      BT                 1.3 - 5.4%         2.6%     See note 3

% women who smoked at any time

during pregnancy                 BT                   n/a           7.9%     See note 4

9

Children’s Education

Australian Early Development

Census (AEDC) 2015 % children on track on all five domains % children vulnerable on one or more domains % children vulnerable on two or more domains % students who attend school more than 90% of time (Yr 1-10)

Broomehill PS 2019

2021

Tambellup PS 2019

2021

Year 3 NAPLAN results, 2019 % achieving Reading benchmark % achieving Numeracy benchmark % homes with internet access

Language

% people who speak a language other than English at home Family functioning

Income

Time

Human capital

Psychological capital

Social capital

Community

Highest level of school completed %<Yr10 % Yr 10 % Yr 11 % Yr 12 Post-school qualifications % Certificate/Diploma % Bachelors degree or higher % With a post-school qualification Socio-economic index

SEIFA IRSD Score

Percentile (within WA) Rank (within WA)

Location Location Value Comments

WA Average

*AEDC results for the Shire of Broomehill-Tambellup are reported for 2015, as 2018 and 2021 results for

this Shire were not published due to small counts See note 5 BT 57.9* 57.9%

For Broomehill-Tambellup

BT 26.3* 19.4% N=19

BT 10.5* 9.4% See note 6

BT 81% NA

BT 92% NA 2021 attendance levels BT 78% NA may have been adversely BT 54% NA affected by COVID-19

*NAPLAN results for the Shire of Broomehill Tambellup are reported for 2019, as 2021 results for this Shire were not published due to small

counts See note 7 BT 100%* 96.0% For Broomehill-Tambellup

BT 100%* 95.3% N=17

BT 72.1% 85.1%

Figures below include people who speak English and another language plus people who only speak another language at home

BT 15.3% 19.4% See note 8 Measures for these vital resources and risks are not easy to find in publicly available data, but they are included in the proposed survey of parent-caregivers for the EY! Evaluation Below figures don’t add up to 100% due to not stated and rounding See note 9 BT 11.3% 7.5% BT 24.6% 20.2% BT 10.1% 9.2% BT 39.0% 53.5% See note 9 BT 24.6% 29.3% BT 9.9% 20.5% BT 52.8% 61.1% See note 10 BT 950 NA LGAs ranked from lowest BT 26 NA score (rank=1) to highest BT 35 NA score (rank=137)

10

TELETHON

INSTITUTE

telethonkids.org.au

Discover. Prevent. Cure.

Item Location Location Value WA Average Comments

Economy

Workforce Participation

% work Full Time                BT                59.4%          57.0%     See note 11

% work Part Time               BT                25.0%          30.0%

% unemployed                  BT                 7.0%           7.8%

% temporarily away from work     BT                 7.4%           5.2%

Parental employment See note 11 % children 0-4 with at least one

parent employed                BT                78.8%          85.7%

% children 0-4 with no parent

employed                      BT                16.3%         14.3%

Income See note 11 % family households with income

less than $500 per week          BT                 4.9%           4.9%

% family households with income

$500 to less than $1,000 per week  BT                25.3%          15.5%

% family households with income

$3,000 or more per week          BT                13.1%         21.7%

11

Evidence Partner

TELETHON

INSTITUTE

GNOWANGERUP LOCAL GOVERNMENT AREA Ke Pal

DATA SNAPSHOT 9

Number of Os @) EI Ber Sa0 5 TOTAL POPULATION

children ne 1.215 i

aged 0-4 Vaccination rates 0 0 t@) Source: ABS (2014) FY 15.6% 3.3% 18 £3 89.5% of Albany SA3 90 of children of children of babies had children are fully immunised 0-4 ore 04 cre Source: ABS (2018) low birth weight (<2,500g) at2 old pe leuk Aboriginal CALD (WA average 6.5%) are yearn oc Index of relative

(WA aver age 91-496) socio-economic

Source: ABS (201 4) Source: ABS (2014) Source: COA (2018) disdvantage

FAMILIES

ol, | Family moxewe a i &

HOSPITALISATION RATES FOR 0-4 YEAR OLDS

39.7% with child na, me NES yf 11.4% one parent Oral Disease related Chronic Physical illness 116 Gnowangerup = 998 Families with children under 15 44.0% no children 1.6% other Numbers too small to report = Numbers too small to report which is in the

Source: ABS |2014]) Source: ABS (201 4] sith decile

(WA average 0.8 per 100 persons) (WA average 4.3 per 100 persons) Source: ABS (2014)

Source: CDA, (2010) Source: CDA (2018) prese ns

of women smoked Women who drank alcohol a per 100 ET 9 8 9 8 8 % during pregnancy during pregnancy (WA average 0.8) per 100 persons of residents are

WA average 7.7% ( + ) Numbers too small to report Numbers too smaill to report Source: CDA (2018) (WA average 70.7) Aboriginal

Source: Stork Perinatal Database Source: ABS (2014)

Source: CDA (2018) Sources store ie Database (2019) FAMILY AND DOMESTIC VIOLENCE e 10 0% 8. ¥% Reported FDV Numbers unavailable for I . of births were to Incidents Gnowangerup 5 90% f birth: i 2014-2020 or etins were N° mothers with a mental illness f sid KC women aged 15-17 (WA average 10.2%) o ave are (wa average 2.6%) cere

Source: ABS (2014)

5. Gnowangerup Item Location Location Value WA Average Comments

Children

% children 0-4 in sole parent family   Gn                 11.5%        12.8%     See note 1

% children 0-4 who don’t speak

English well or not at all                                  3.3%         9.0%

Family make-up See note 2

Couple family with children        Gn                 39.7%        45.3%

Couple family no children         Gn                 44.0%        38.5%

One parent family              Gn                 11.4%        14.5%

Other family                  Gn                  1.6%         1.7%

Child Health

Child health figures and hospitalisation rates below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% babies with low birth weight      Gn                  9.0%         6.5%

% babies born pre-term           Gn                  7.0%         8.6%

% fully immunised at 2 years old       Albany SA3          89.5%        91.4%

0-4 yr old hospitalisations rates (per 100 children aged 0-4 yrs)

Ear and hearing                Gn                    0.3 - 1.5          1.9

Hospitalisation rates are the  Respiratory disease             Gn                    0.3 - 1.5          0.8

number of hospitalisations

Vaccine preventable diseases      Gn                    0.1 - 0.8          0.2     per 100 children in the

Injury                       Gn                    1.1 - 4.5          2.3     community

Maternal Health

Maternal health figures below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% births to women aged 15-19       Gn                 10.0%         2.6%     See note 3

% women who smoked at any time

during pregnancy                Gn                 10.7%         7.9%     See note 4

13

Item Location Location Value WA Average Comments

Children’s Education

Australian Early Development

Census (AEDC) 2021 See note 5 % children on track on all five

domains                     Gn                 70.6%        57.9%

% children vulnerable on one or For Gnowangerup

more domains                 Gn                 11.8%        19.4%            N=17

% children vulnerable on two or

more domains                 Gn                  5.9%         9.4%

% students who attend school more than 90% of time (Yr 1-10) See note 6

Gnowangerup DHS      2019     Gn                57%        NA

2021     Gn                62%

2021 attendance levels Borden PS             2019     Gn                75%        NA

may have been adversely

2021     Gn                38%                                                                                        affected by COVID-19

Ongerup PS            2019     Gn                92%

2021     Gn                33%

NAPLAN results are provided for Gnowangerup DHS only, as results are

Year 3 NAPLAN results, 2021             unavailable for Borden PS or Ongerup PS       See note 7

% achieving Reading benchmark    Gn                100%        96.0%       For Gnowangerup DHS

% achieving Numeracy benchmark   Gn                100%        95.3%           N= 12

% homes with internet access       Gn                 80.1%        85.1%

Figures below include people who speak English and another language plus people Language who only speak another language at home % people who speak a language

other than English at home         Gn                 15.4%        19.4%

Family functioning Income See note 8 Time Measures for these vital resources and risks are not easy to find in publicly available data, but they areHuman capital included in the proposed survey of parent-caregivers Psychological capital for the EYI Evaluation Social capital

14

Item Location Location Value WA Average Comments

Community

Below figures don’t add up to 100% due to Highest level of school completed not stated and rounding See note 9 %<Yr10 Gn 8.7% 7.5% % Yr 10 Gn 27.1% 20.2% Figures don’t add to 100% % Yr 11 Gn 9.0% 9.2% due to ‘not-stated’ and % Yr 12 Gn 41.0% 53.5% rounding Post-school qualifications See note 9 % Certificate/Diploma Gn 26.3% 29.3% % Bachelors degree or higher Gn 9.3% 20.5% % With a post-school qualification Gn 51.1% 61.1% Socio-economic index See note 10 SEIFA IRSD Score Gn 998 NA LGAs ranked from lowest Percentile (within WA) Gn 57 NA score (rank=1) to highest Rank (within WA) Gn 78 NA score (rank=137)

Economy

Workforce Participation

% work Full Time Gn 65.5% 57.0% See note 11 % work Part Time Gn 24.6% 30.0% % unemployed Gn 3.2% 7.8% % temporarily away from work Gn 5.8% 5.2% Parental employment See note 11 % children 0-4 with at least one parent employed Gn 70.5% 85.7% % children 0-4 with no parent employed Gn 6.4% 14.3% Income See note 11 % family households with income less than S500 per week Gn 8.8% 4.9% % family households with income $500 to less than $1,000 per week = Gn 16.9% 15.5% % family households with income $3,000 or more per week Gn 14.7% 21.7% 15

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KATANNING LOCAL GOVERNMENT AREA a

pik AN

DATA SNAPSHOT oer

Number of Q Births per year to TOTAL POPULATION children Katanning residents 4,151

INSTITUTE

aged 0-4 Vaccination rates ‘@) (8) &} Souree: ABS (201 4) of Albany 5A3

of colcren of epicten | ates ) children are fully immunised

Source: ABS (2018) ow weig 9, at 2 years old i Source: ABE (2016) boriginal CALD Index of relative gine (WA average 6.5%) (WA average 91.4%) socio-economic

Source: ABS (201 4} Sourcec ABS (2014) Source: CIV, (2018) Source: CDA (2018) disdvantage

ay Family make-up anon B 39.3% with children ff 15.1% one parent ¥ yf . Ppa Oral Disease related Chronic Physical Illness Katanning = 906 Families with children under 15 44.3% no children 2.5% other 24 6.4 when sin ine Source: ABS (2014) Sourtec ABS (2014) , , per 100 persons per 100 persons Source: ABS (2018)

(WA average 0.8) (WA average 4.3)

Source: CO, (2018) Source: CDA (2018)

MATERNAL HEALTH

A “a DIVERSITY

1 8. 8% a) » ; Respiratory Disease related SS rs 10.6% a 1.9 185.5 a

° women smoked per 100 persons uring pregnancy of women drank alcohol of women used drugs (WA average 0.8) per 100 persons : (WA average 7.9%) 2 ea during creopaney, . (WA average 70.7) of residents are

Source: CDA (2018) Aboriginal

Source: Stork Perinatal Database Source: Stork Perinatal Database Source: ABS (2018)

(2019) (2019) FAMILY AND DOMESTIC VIOLENCE

Source: CDA (2018)

‘0 OU) 8.3% 11.2% . Y f of births were to of births es i Reported fDv i ’ EVA 2014-2020 is 17.6%

women d 15-19 ase mothers with a mental illness ; f residents (WA average 2.6%) (WA average 10.295) ite Ine » ‘s) cap ene

a?

Source: COA [204

id (2018) Source: CDA (2018) Source: ABS (2014)

6. Katanning Item Location Location Value WA Average Comments

Children

% children 0-4 in sole parent family    Ka                  20.3%          12.8%     See note 1

% children 0-4 who don’t speak

English well or not at all                                 15.7%            9.0%

Family make-up See note 2

Couple family with children         Ka                  39.3%          45.3%

Couple family no children           Ka                  44.3%          38.5%

One parent family                Ka                  15.1%          14.5%

Other family                     Ka                   2.5%            1.7%

Child Health

Child health figures and hospitalisation rates below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% babies with low birth weight       Ka                   8.7%            6.5%

% babies born pre-term             Ka                   7.3%            8.6%

% fully immunised at 2 years old       Albany SA3          89.5%          91.4%

0-4 yr old hospitalisations rates (per 100 children aged 0-4 yrs)

Ear and hearing                  Ka                        2.2               1.9

Hospitalisation rates are  Respiratory disease               Ka                        1.9               0.8

the number of

Vaccine preventable diseases       Ka                     0.0 - 0.1             0.2      hospitalisations per 100

Injury                           Ka                     0.4 - 1.7             2.3      children in the community

Maternal Health

Maternal health figures below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% births to women aged 15-19        Ka                   8.3%            2.6%     See note 3

% women who smoked at any time

during pregnancy                  Ka                  18.8%            7.9%     See note 4

17

Item Location Location Value WA Average Comments

Children’s Education

Australian Early Development

Census (AEDC) 2021 See note 5 % children on track on all five

domains                        Ka                  50.0%          57.9%

% children vulnerable on one or For Katanning

more domains                   Ka                  28.0%          19.4%           N=50

% children vulnerable on two or

more domains                   Ka                  18.0%            9.4%

% students who attend school more than 90% of time (Yr 1-10) See note 6

Katanning PS          2019      Ka                 67%           NA

2021      Ka                 58%           NA    2021 attendance levels

Braeside PS            2019      Ka                 68%           NA    may have been

2021      Ka                 67%           NA     adversely affected by

St Patrick’s School      2019      Ka                 82%           NA    COVID-19

2021      Ka                 78%           NA

NAPLAN results are provided for Katanning PS and Braeside PS only, as results are unavailable

Year 3 NAPLAN results, 2021                          for St Patrick’s School                See note 7

% achieving Reading benchmark     Ka                 93%          96.0%          For Katanning

% achieving Numeracy benchmark   Ka                 85%          95.3%           N=22

% homes with internet access        Ka                  72.2%          85.1%

Figures below include people who speak English and another language plus people Language who only speak another language at home % people who speak a language

other than English at home          Ka                  32.5%          19.4%

Family functioning Income See note 8 Time Measures for these vital resources and risks are not easy to find in publicly available data, but they are included inHuman capital the proposed survey of parent-caregivers for the EYI

Psychological capital Evaluation

Social capital

18

Item Location Value WA Average Comments

Community

Below figures don’t add up to 100% due to

Highest level of school completed not stated and rounding See note 9 %<Yr10 Ka 18.1% 7.5%

% Yr 10 Ka 22.5% 20.2% Figures don’t add to % Yr 11 Ka 9.8% 9.2% 100% due to ‘not % Yr 12 Ka 32.0% 53.5% stated’ and rounding

Post-school qualifications See note 9 % Certificate/Diploma Ka 23.6% 29.3%

% Bachelors degree or higher Ka 8.3% 20.5% % With a post-school qualification Ka 49.8% 61.1%

Socio-economic index See note 10 SEIFA IRSD Score Ka 906 NA LGAs ranked from Percentile (within WA) Ka 10 NA lowest score (rank=1)

to highest score Rank (within WA) Ka 13 NA (rank=137)

Economy

Workforce Participation

% work Full Time Ka 61.7% 57.0% See note 11 % work Part Time Ka 26.4% 30.0%

% unemployed Ka 6.1% 7.8% % temporarily away from work Ka 6.2% 5.2%

Parental employment See note 11 % children 0-4 with at least one parent employed Ka 67.5% 85.7%

% children 0-4 with no parent employed Ka 19.8% 14.3%

Income See note 11 % family households with income less than S500 per week Ka 6.8% 4.9%

% family households with income $500 to less than $1,000 per week Ka 23.1% 15.5% % family households with income $3,000 or more per week Ka 11.3% 21.7% 19

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KOJONUP LOCAL GOVERNMENT AREA 1

DATA SNAPSHOT oF

Number of On @) ee to y 9 6 TOTAL POPULATION children ore 1,985

INSTITUTE

aged 0-4 Vaccination rates (a) ie) 0 Source: ABS (201 4) 1 0.5% 2% 24 6.5 % 89.5% of Albany SA3 152 of children of children of babies had children are fully immunised 04 are O04 are 7 low birth weight (=2,500

Sovmoes ABS Aboriginal CALD a Se WA aver = 596) ab si2 yous old Index of relative

age 6. (WA overage, 31.4%) socio-economic

Source: ABS. (201 4) Sources ABS (2014) Sourcec CDM (2018) disdvantage

FAMILIES HOSPITALISATION RATES FOR 0-4 YEAR OLDS

ty Family mae ai &

Ra, 40.1% with chilcren if Meat [pe Oral Disease related Chronic Physical illness Koj _ ojonup = 999 Families with children under 15 nh 48.9% no children 0.8% other Numbers too small to report 8 0 which is in the source: ABS (3014) Source: ABS (2014) (WA average 0.8) per 100 persons sixth decile (WA average 4.3) eweccnetens

ee ee ] 94% ) ° S Ear and Heoring related Emergency Dept e.

0 presentations 9.1% 4.5% Su, 130.7 of women smoked per 100 persons 0 46% espe ge 8.4%) o crank alcohol ete os ts (WA average 1.9) eo et peal of residents are ied during pregnancy during pregnancy Source: CDA (2018) am SD al Shu Aboriginal

Source: Stork Perinatal Database Source: Stork Perinatal Database Source: ABS (2014)

Births to 2. 7% Reported FDV Numbers unavailable for : f women aged 15-19 of births were to Incidents Kojonup 0.7% - 2.9% 2014-2020 4.9% mothers with a mental illness ; (wa average 2.6%) (WA average 10.2%) of residents are

CALD

Source: ABS (2014)

Source: CDA (201

Meest) Source: CDA [2018}

7. Kojonup Item Location Location Value WA Average Comments

Children

% children 0-4 in sole parent family    Ko                 14.5%              12.8%     See note 1

% children 0-4 who don’t speak

English well or not at all                                 2.0%               9.0%

Family make-up See note 2

Couple family with children         Ko                 40.1%              45.3%

Couple family no children          Ko                 48.9%              38.5%

One parent family                Ko                 10.8%              14.5%

Other family                    Ko                  0.8%               1.7%

Child Health

Child health figures and hospitalisation rates below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% babies with low birth weight       Ko                  6.5%               6.5%

% babies born pre-term             Ko                 10.1%               8.6%

% fully immunised at 2 years old       Albany SA3          89.5%              91.4%

0-4 yr old hospitalisations rates (per 100 children aged 0-4 yrs)

Ear and hearing                 Ko                       3.9                   1.9      Hospitalisation rates

are the number of  Respiratory disease               Ko                    0.2 - 0.9                  0.8

hospitalisations per 100

Vaccine preventable diseases       Ko                    0.0 - 0.1                  0.2                                                                                                            children in the

Injury                         Ko                    0.7 - 1.7                  2.3     community

Maternal Health

Maternal health figures below have been sourced from the WA Child Development Atlas. Where small counts have been suppressed, ranges have been provided based on minimum and maximum values.

% births to women aged 15-19       Ko                  0.7 - 2.9%              2.6%     See note 3

% women who smoked at any time

during pregnancy                 Ko                 19.4%               7.9%     See note 4

21

Item Location Location Value WA Average Comments

Children’s Education

Australian Early Development

Census (AEDC) 2021 See note 5 % children on track on all five

domains                       Ko                 51.5%              57.9%

% children vulnerable on one or For Kojonup

more domains                   Ko                 33.3%              19.4%          N=33

% children vulnerable on two or

more domains                   Ko                 18.2%               9.4%

% students who attend school more than 90% of time (Yr 1-10) See note 6

Kojonup DHS           2019                       61%             NA      2021 attendance

2021                       66%                               levels may have been

St Bernard’s School     2019                       83%                            adversely affected by

2021                       85%             NA         COVID-19

NAPLAN results are provided for Kojonup DHS only,

Year 3 NAPLAN results, 2021            as results are unavailable for St Bernard’s School      See note 7

% achieving Reading benchmark     Ko                97%              96.0%       For Kojonup DHS

% achieving Numeracy benchmark   Ko                97%              95.3%          N=29

% homes with internet access        Ko                 73.0%              85.1%

Figures below include people who speak English and another language plus people who Language only speak another language at home % people who speak a language

other than English at home          Ko                 13.4%              19.4%

Family functioning Income See note 8 Time Measures for these vital resources and risks are not easy to Human capital find in publicly available data, but they are included in the Psychological capital proposed survey of parent-caregivers for the EYI Evaluation Social capital

22

Item Location Location Value WA Average Comments

Community

Below figures don’t add up to 100% due to

Highest level of school completed not stated and rounding See note 9 %<Yr10 Ko 9.3% 7.5%

% Yr 10 Ko 25.6% 20.2% Figures don’t add to % Yr 11 Ko 8.7% 9.2% 100% due to ‘not % Yr 12 Ko 44.3% 53.5% stated’ and rounding

Post-school qualifications See note 9 % Certificate/Diploma Ko 24.8% 29.3%

% Bachelors degree or higher Ko 12.9% 20.5% % With a post-school qualification Ko 52.6% 61.1%

Socio-economic index See note 10 SEIFA IRSD Score Ko 999 NA LGAs ranked from Percentile (within WA) Ko 58 NA lowest score (rank=1)

to highest score Rank (within WA) Ko 79 NA (rank=137)

Economy

Workforce Participation

% work Full Time Ko 62.1% 57.0% See note 11 % work Part Time Ko 28.1% 30.0%

% unemployed Ko 2.5% 7.8% % temporarily away from work Ko 7.5% 5.2%

Parental employment See note 11 % children 0-4 with at least one parent employed Ko 76.1% 85.7%

% children 0-4 with no parent employed Ko 15.2% 14.3%

Income See note 11 % family households with income less than S500 per week Ko 7.0% 4.9%

% family households with income $500 to less than $1,000 per week Ko 19.5% 15.5% % family households with income $3,000 or more per week Ko 14.2% 21.7% 23

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8. Notes on research evidence about quantitative data 1 Sole-parent families In the Central Great Southern community, almost one-fifth (17.1 per cent) of children in the 0-4 years age range live in a sole-parent family, compared to the Western Australian average of 12.8 per cent. Sole parents with young children may face multiple layers of adversity: they are typically on a low income, have very little spare time to focus on themselves or their children, are under constant pressure and stress (no money, no time and lots of responsibility), may have few resources to drawn on (i.e.: no partner to help, limited life experience and educational opportunities which limit employment and other opportunities) and are often socially isolated1. Support for sole-parent families has to be multi-faceted, simultaneously working towards reducing any sense of social isolation they may experience while also addressing their material needs (food, clothing, other cost items), providing opportunities for them to ‘give back’ and feel worthwhile (reciprocity) and providing clear and accessible information that builds their sense of empowerment and confidence2.

2 Family make-up These categories of ‘family make-up’ are set by the ABS and may not be meaningful for definitions of ‘family’ among some cultural groups, including for Aboriginal peoples and CaLD community members. Further, in ABS Census data, a lot of the available tables are based on ‘couple’ families, ‘sole-parent’ families, or ‘other’ family types, the latter of which includes grandparent families. This means it is not possible to look specifically at grandparent families in detailed ABS tables an important dimension of family types in the Central Great Southern community may be invisible in the data. Advice from the community on whether this is something that should be considered more closely will be valuable.

3 Teen mothers The incidence of teen mothers in the Central Great Southern is double the Western Australian average. Infants born to teenage mothers are more likely to be preterm and have low birthweight, both of which predict poor long-term health outcomes for the child3. Teen mothers are strongly associated with sole-parent families and compounding adversity associated with household poverty, limited time, reduced day-to-day support and challenging home circumstances (as per note 1 above). Socioeconomic and educational disadvantage associated with teen pregnancy can endure across generations, however the adverse maternal and neonatal impact can be reduced with targeted antenatal and postnatal support7. The relatively high incidence of teen pregnancy in the Central Great Southern likely contributes to normalisation of such circumstances among teenagers and makes it more difficult to change because young women are especially motivated to ‘fit in’ and pregnancy may entail kudos and attention among their peers. However, studies have also found that young women often show

1 Zubrick, S., Williams, A.A., Silburn, S. and Vampani, G., 2000. Indicators of Social and Family Functioning, Department of Family and Community Services, Commonwealth of Australia 2 Zubrick, S., 2018. Circumstances for healthy children and empowered communities, Early Years Initiative Workshop for the Department of Communities, Port Hedland, 28 November 2018 3 Mann, L, Bateson, D. and Black, K (2021). “Teenage pregnancy” in Australian Journal of General Practice Vol 49, No 6., June 2020. Accessed 15 February 2022 via Infants born to teenage mothers are more likely to be preterm, have low birthweight and be small for gestational age 24

high levels of resilience and use any resources available to them to make their lives, and their children’s lives, happy and meaningful4.

4 Smoking during pregnancy Pregnant women in the Central Great Southern are more than twice as likely to smoke during pregnancy compared with the Western Australian average. Smoking in pregnancy is a modifiable risk factor for low birthweight, pre-term birth and placental complications because tobacco smoke reduces the flow of oxygen to the placenta and exposes the foetus to a number of toxins. Exposure to these toxins during the first 20 weeks of pregnancy are especially harmful and are associated with sudden infant death syndrome (SIDS), childhood cancers, high blood pressure, asthma, skin infections, obesity and lowered cognitive development5. As with teen pregnancy (note 3, above) normalisation of this behaviour among young women in the Central Great Southern may make it especially difficult to change.

5 Australian Early Development Census (AEDC)

The AEDC is conducted across Australia every three years when children are in their first year of full-time schooling. Pre-primary teachers complete the AEDC for each child in their class, contributing to a community-level measure of local children’s development on five domains: physical health and wellbeing; social competence; emotional maturity; language and cognitive skills (school based); communication skills; and general knowledge. These areas of child development are important predictors of adult health, education and social outcomes6 . Results from the 2021 AEDC show that five-year-olds in the Central Great Southern are more likely than their Western Australian peers to be developmentally vulnerable on one or more domains (i.e.: 27.0 per cent for the Central Great Southern compared with a Western Australian average of 19.4 per cent) and on two or more domains (16.0 per cent compared with a Western Australian average of 9.4 per cent). Conversely, children in the Central Great Southern are less likely to be on track on all five domains than the Western Australian average (54.0 per cent and 57.9 per cent respectively). Children who start school behind with developmental vulnerabilities tend to stay behind. These data reiterate the importance of the EYI for this community, especially in light of strong evidence that it is possible for communities to ‘restack’ the odds of children achieving favourable outcomes through a combination of health, early learning and family supports7.

6 School attendance There is a direct relationship between school attendance and school achievement – children

4 Hoffmann, H.,Lam, J. and Baxter, J. (2021). Young Mothers in Australia: prioritising motherhood and resisting stereotypes. Life Course Centre Working Papers Series, 25 November 2021. Accessed 14 February 2022 via https://lifecoursecentre.org.au/working-papers/young-mothers-in-australia-prioritising-motherhood-and-resisting stereotypes/ 5 Australian Institute of Health and Welfare, 2021. Australia’s mothers and babies; Smoking during pregnancy. Accessed 15 February via https://www.aihw.gov.au/reports/mothers-babies/australias-mothers babies/contents/antenatal-period/smoking-during-pregnancy 6 Commonwealth of Australia and Department of Education, Western Australia, 2019. Early childhood development for children living in Western Australia by region: Australian Early Development Census 2018. Accessible via https://www.education.wa.edu.au/dl/vnnm73 7 Goldfeld, S., Villanueva, K., Lee, J.L., Robinson, R., Moriarty, A., Peel, D., Tanton, R., Giles-Corti, B., Woolcock, G., Brinkman, S., Katz, I. (2017). Foundational Community Factors (FCFs) for Early Childhood Development: A report on the Kids in Communities Study. Accessed 23 December 2021 via https://www.rch.org.au/uploadedFiles/Main/Content/ccch/CCCH-KICS-Final-Report-April-2018.pdf 25

who attend regularly do better at school8. There is a high level of variability in the percentage of students in the Central Great Southern community (Years 1 – 10) who attend school at least 90 per cent of the time9. Some schools have achieved very high levels of attendance, while others have low levels. Attendance in 2021 may have been affected by COVID-19, with some schools having particularly low attendance levels. Research points to the importance of children being supported by schools and their families to establish the habit of regular attendance from Kindergarten onwards10 and for schools to have strategies in place to ensure they are interesting and engaging for students, culturally safe and provide prompt follow-up on all unexplained absences to emphasise the importance of regular attendance.

7 National Assessment Program for Literacy and Numeracy (NAPLAN) While the measure of a child’s success at school (and life beyond school) is far more complex than his or her score in NAPLAN tests, literacy and numeracy are essential foundational skills for success in life and there is strong evidence that children who do not achieve the National Minimum Standard (the benchmark) for Reading and Numeracy when they are in Year 3 are unlikely to catch-up with their age-group peers and will struggle throughout their education11. 2021 NAPLAN results from primary schools in the Central Great Southern for Year 3 Reading were comparable to Western Australian averages (i.e.: 95 per cent for the Central Great Southern met or bettered the National Minimum Standard (NMS) score compared with 96 per cent for Western Australia). However corresponding results for Numeracy were lower (i.e.: 91 per cent for the Central Great Southern compared with a Western Australian average 95.3 per cent, meaning the proportion of Year 3 children in the Central Great Southern who did not meet the NMS for Numeracy was almost twice the Western Australian average).

8 Family functioning While data are available about child development, health and education outcomes, limited amounts of robust data are available on the social and family factors that influence positive or negative child outcomes. To help address this gap, a collaborative national project developed an evidence-based framework for tracking social and family factors that jointly influence children’s outcomes12. The ‘social and family functioning’ framework includes five inter-related elements: family income; family time (i.e.: time caregivers have for themselves or their children); human capital (i.e.: caregiver’s knowledge, experience and skills about healthy choices and how the world works); psychological capital (i.e.: life satisfaction, confidence, worries, self-efficacy and conflict); and social capital (i.e.: sense of connectedness, civic engagement, safety and community cohesion). Unfortunately, quantitative data on these five social factors are not readily available at this time, so data items such as ‘sole-parent families’ are often used as a proxy (see note 1 in this section). To help address these gaps in the quantitative data available

8 ACARA. (2019). Student attendance. Retrieved February 1, 2022, from http://www.acara.edu.au/reporting/national report-on-schooling-in-australia-data-portal/student-attendance 9 My School. (2019). Retrieved February 22, 2022, from https://www.myschool.edu.au/ 10 Hancock, K. J., Shepherd, C. C. J., Lawrence, D., & Zubrick, S. R. (2013). Student attendance and educational outcomes: Every day counts. Report for the Department of Education, Employment and Workplace Relations, Canberra. https://doi.org/10.13140/2.1.4956.6728. 11 de Carvalho, D. (2019). ‘ACARA: NAPLAN and Aboriginal and Torres Strait Islander students’ in Education Matters Magazine, online version accessed 12 December 2021 via https://www.educationmattersmag.com.au/acara naplan-and-aboriginal-and-torres-strait-islander-students/ 12 Zubrick, S., Williams, A.A., Silburn, S. and Vampani, G., 2000. Indicators of Social and Family Functioning, Department of Family and Community Services, Commonwealth of Australia 26

for the Central Great Southern community, the Evaluation of the EYI will address these factors via the parent-caregiver survey that will conducted in each of 2022, 2024 and 2027 to track changes over time.

9 Levels of education in the community Fewer than half (37.1 per cent) of Central Great Southern community members completed Year 12 (or equivalent). This is considerably lower than the 53.5 per cent for Western Australia overall. Conversely, the proportion who only completed Year 10 is higher than the Western Australian average (Year 10 attainment 13.8 per cent in the Central Great Southern compared with 20.2 per cent in Western Australia). Also, a lower proportion of people from the Central Great Southern have a post-school qualification from TAFE or university (i.e.: 51.0 per cent compared to 61.1 per cent for the state). These data should be considered in light of landmark longitudinal research which found that the primary caregiver’s (usually the mother’s) level of education is a strong predictor of that child’s lifetime success13. However, the same research found two other important things. Firstly, that participating in high quality preschool (through early learning centres, playgroups and Kindergarten) before children start full-time Pre-primary is particularly beneficial for disadvantaged children, especially in groups of children with a blend of different social backgrounds. Secondly, the study found that the child’s home learning environment is extremely important: “For all children, the quality of the home learning environment is more important for intellectual and social development than parental occupation, education or income. What parents do is more important than who parents are”14. It follows that multi-generational early learning programs such as supported playgroups through the Child and Parent Centre, Champion Centre, KindiLink and local schools may be especially effective in simultaneously building the confidence and capability of families while also focusing on children’s learning.

Creating a rich home learning environment does not mean turning home into a school; rather, it means making home a fun, calm, secure and cognitively stimulating place, shared with people the child trusts and feels a strong attachment to. Key features include predictable routines, frequent sustained ‘serve and return’15 conversations with children (from birth, even when the child can only ‘babble’), engaging the child in daily household activities (e.g.: cooking, cleaning, shopping, etc.), consistent and calm responses to behaviour, playing and reading with the child daily, stimulating out-of-home experiences with friends, family and other children (e.g.: in parks, the bush, a library or at a river) and having a regular bedtime16.

13 Sylva, K., Melhuish, E., Sammons, P., Siraj-Blatchford, I. & Taggart, B. (2004). The Effective Provision of Pre-school Education (EPPE) Project: Findings from pre-school to end of key stage 1. Nottingham, United Kingdom: Department for Education and Skills. Accessible via https://ro.uow.edu.au/cgi/viewcontent.cgi?article=3155&context=sspapers 14 Quote from p.1 of Sylva, K., Melhuish, E., Sammons, P., Siraj-Blatchford, I. & Taggart, B. (2004). The Effective Provision of Pre-school Education (EPPE) Project: Findings from pre-school to end of key stage 1. Nottingham, United Kingdom: Department for Education and Skills. Accessible via https://ro.uow.edu.au/cgi/viewcontent.cgi?article=3155&context=sspapers 15 Harvard Center on the Developing Child, December (2009). Working Paper No. 1: Young children develop in an environment of relationships, accessed 7 February 2022 via https://www.albertafamilywellness.org/resources/doc/working-paper-1-young-children-develop-in-an-environment of-relationships 16 Yu, M. and Daraganova, G. (2014). “Children’s early home learning environment and learning outcomes in the early years of school”, Chapter 4, Longitudinal Survey or Australian Childre Annual Statistical Report 2014. Accessed 7 27

10 Socio-economic index for areas — index of relative socio-economic disadvantage (SEIFA IRSD)

The SEIFA-IRSD17 is a statistic generated for every statistical area across Australia by the ABS using selected data items from that national Census conducted every five years. The SEIFA-IRSD summarises key information about the economic and social conditions of people and households

11

within a specified geographical area. A low score indicates that cumulative and compounding features of economic and social disadvantage are prevalent within the community including many households with low-income and many people with low qualifications and low-skill occupations. While there is variation in SEIFA-IRSD scores across the Central Great Southern, the Local Government Area (LGA) of Katanning is in the lowest 10% of LGAs across Western Australia. A low SEIFA-IRSD is strongly associated with poor AEDC results for a community (see note 5), and points to the entrenched disadvantage faced by families and children in the community. However, this index does not define a community and many communities perform better (or worse) than their SIEFA-IRSD score might predict. The EYI exists to work alongside the Central Great Southern community to implement strategies which will enable it to perform better than might be predicted by its low SEIFA-IRSD.

Workforce participation and income levels

Data on workforce participation for the Central Great Southern community show a lower rate of unemployment than the Western Australian average (4.9 per cent compared to 7.8 per cent). However, only 72.0 per cent of children aged 0-4 in the Central Great Southern have at least one parent employed, compared to 85.7 per cent for Western Australia. Unemployment and the associated lack of financial resources can create stress for families and may perpetuate intergenerational disadvantage because parental workforce participation and daily modelling of the ‘habit’ of going to work (or not) can impact their children’s future joblessness18. It is also important to note, however, that the impact of parental employment is not one-dimensional. While working parents can provide a positive role model for their children and their employment income can pay for more items and benefits, some jobs may entail poor working conditions, low pay, job insecurity or having to work away from home and can lead to increased stress levels in households. Also, families require assured access to affordable, quality childcare19.

The proportion of family households in the Central Great Southern community with income below $500 per week is only slightly higher than that of the Western Australian average (6.9 per cent and 4.9 per cent respectively), but only 12.8 per cent have an income of at least $3,000 per week, compared to 21.7 per cent across the state. This indicates a universal modest level of income across the community and limited access to discretionary expenditure or to savings for a ‘rainy day’.

17

18

19

February 2022 via http://talkingtogether.com.au/wp-content/uploads/2018/09/childrens-early-home-learning environment-and-learning-outcomes-in-the-early-years-of-school.pdf

Australian Bureau of Statistics, 2018. 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. From ABS website at https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001~2016~Main%20Features~IRSD~19

Tanton, R., Dare, L., Miranti, R., Vidyattama, Y., Yule, A. and McCabe, M. (2021), Dropping Off the Edge 2021: Persistent and multilayered disadvantage in Australia, Jesuit Social Services: Melbourne

Heinrich CJ. Parents’ employment and children’s wellbeing. The future of children. 2014 Apr 1:121-46. 28

TELETHON

KIDS telethonkids.org.au

Discover. Prevent t. Cure,

Ear, Nose & Throat Referral Pathway

Improving the journey for our community

Early Years Initiative / WA Country Health Service – Great Southern Population Health

2022

Case Study

Introduction

Health service improvements for families of 0 – 4-year old’s has been the focus of the Early Years Initiative Program Officer in the Central Great Southern (CGS) since the inception of the position in November 2019. Having 0.2 FTE dedicated to the role, time has been allocated to unpack the system local families must navigate to access health care. Ear, Nose and Throat (ENT) infections were identified as one of the top 4 health issues impacting on 0 – 8-year old’s in the CGS. Poor hygiene and a lack of nose blowing were attributed to the rate of infections. Further to this, local families reported that ENT specialist services were inaccessible. The purpose of this case study is to outline how a complex system was able to be simplified, ensuring service providers and families could attain better health outcomes for 0 – 4-year old’s in the CGS region.

Background

Katanning Primary Health Service receives funding from Rural Health West to provide visits from an ENT specialist from Perth Children’s Hospital, an audiologist and an anesthetist. This is managed by the Primary Health Manager, who works closely with Primary Health administration, Great Southern Aboriginal Health Service (GSAHS), speech pathology department, child health nurse team and the hospital pre-admission nurse.

Local management  of  the Ear  Health program  enables  suitable  appointments  to be made and ensures

recommendations are followed up. All children attending universal health checks are screened for hearing (from birth to 2 years of age). School health nurses and speech pathologists also conduct screening. GSAHS conduct screening of all Aboriginal children at kindergarten, pre-primary and year 1. GSAHS then refer the child to a GP for a referral to see the ENT. Extensive consultation with local families and service providers through various methods including surveys, focus groups, discussions at community meetings and informal conversations in well-established relationships revealed a perception that ENT services were lacking in the region. Inaccessibility was reportedly resulting from: services not being available locally or at suitable times, waiting lists and mail taking longer than anticipated resulting in appointments being missed. There was no waitlist for the ENT service, which was at odds with what local families were saying. Initially, it was assumed that the local GPs were referring into the local clinics, however some were still referring to private ENTs in Perth. Untangling these perceptions has resulted in the development of the ENT Health Referral Pathway (Appendix 1), linking families with free services provided in Katanning four times per year.

Goals

• Increase knowledge amongst service providers regarding the availability of audiology and ENT services
• Develop clearer pathways/communication channels

Strategy

Using a systems approach, several barriers were uncovered and worked on to ensure families were able to access the local, free services available. This required going back to the start of the process and mapping out what each step meant for families. Questions put to the system included:

• Why is there no waitlist for the ENT? Is there a breakdown between screening and treatment? 2

• If children do not attend their scheduled universal health check, will hearing issues be missed?
• Are there too many steps involved for families to attend appointments?

Results

• A referral pathway was established with the assistance of the Primary Health Manager, Great Southern

Aboriginal Health Service (GSAHS) staff, Primary Health administration, Great Southern Aboriginal Health

Service (GSAHS), speech pathology department, child health nurse team and the hospital pre-admission nurse.

• This referral pathway has been promoted to the GPs and health service staff. Subsequently, the local GPs have attended a Q&A session with the visiting ENT and audiologist.

• Working closely with GSAHS to ensure clients are getting followed up.

• Have combined the audio/ENT clinics so clients only need to attend on one day for both services.

• The ENT specialist will accept clients without a doctor’s referral (one less appointment/step in the process).

• Upskilling of GSHAS staff in ear pathology, clinical indicators and ear assessment.

• ‘Breath, Blow, Cough’ program has been trialed by the Health Promotion team across schools in the Great Southern and has been recommended to continue. A typical ENT Clinic:

 33 patients over 2 days  20% DNA/cancel on the day (50% of these are non-Aboriginal)  20% waitlisted for surgery in Perth (typically 8)  9% waitlisted for surgery in Katanning (3-4)  9% discharged as treatment complete  1 child over 8 yo will be found to have a significant hearing loss (5 in 2 years) requiring an external hearing device  1 foreign body will be removed

Demographics:

 33% are Aboriginal  10% require an interpreter  10% are Maori  10% are children in care  40% from Kojonup  20% Gnowangerup  30% Katanning  10% Albany/Frankland/Cranbrook Next steps

• Continue to combine ENT/Audiology clinics
• Work on reducing DNA/cancellation rate
• Continue to involve the GPs, pre-admission nurse and GSHAS nurse in ENT clinics
• Continue to promote the importance of ear health
• Continuation of Breath, Blow, Cough program throughout schools in the Great Southern 3

Appendix 1.

Government of Western Australia Ear Health Referral Pathway - Aboriginal Clients

WA, Country Health Service

Screening is conducted by the following service providers:

• Great Southem Aboriginal Health Service (GSAHS) — kindergarten, pre-primary, year 1 (all schools in CSS)
• (Child Health Nurse/School Health Nurse and Speech Pathology u UG

Tympanometry result normal Tympanometry result Type 6 = fluid in middle ear/otitis medial glue ear

Type A Type C = Eustachian tube dysfunction

Le. +50 to -200 daPa = i} ay!

Ear canal volume 0.5c¢-1_5ec

Peak compliance 0.3mL-1.5ml Audiologist appointment — SP appointment Referer decides if child Child must be seen by needs review by GP. GP can refer to NO FURTHER ACTION REQUIRED Audiologist prior to ENT ENT specialist and/or child may require appointment. Refer directly treatment for ear condition. GP to use to audiology using CHIS WACHS Community Health Services E referral (letters- WACHS referral.

referral — child). Referrals sent

to Hearing Australia. |

Discharge from audiology if Results from Hearing Ausiralia to GSAHS and Population Health Clerical. Results into results are within normal a hospital file and/or CHIS (results required if hospital file if referred to ENT). limits. Audiologist refers client to GP for referral to ENT. GSAHS sends referral to clerical at

Primary Health for waitlist to ENT.

NO FURTHER ACTION

REQUIRED | !

Hearing aids fitted. Follow-up am Primary Health waitlists clients on webPas. Adminisiration notifies client and GSHAS

with Hearing Australia as of appointment time. necessary.

NO FURTHER ACTION a

REQUIRED

ENT appointment Client attends ENT clinic. Tonsillectomy = referral to Waitlisted for grommets and/or adenoid removal at Katanning Perth Children’s Hospital. Health Service or PCH. J Pre-admission Nurse to liaise with Waitlist Clerk, Theatre Manager and ENT specialist regarding dates for theatre + GSAHS and Primary Health anaesthetist availability. Client must weigh = 20kgs. Case meetings every 4 months (following ENT clinic). Pre-admission nurse notifies administration of patient outcomes.

\Z 4}

Adminisiration makes appointment for post-surgery review with ENT or further monitoring.

COMMUNITY | COMPASSION | QUALITY | INTEGRITY EQUITY CURIOSITY

COMMUNITY | COMPASSION | QUALITY | INTEGRITY EQUITY | CURIOSITY

Goverment of Wester Australia Ear Health Referral Pathway

WA, Country Health Service

Screening is conducted by: Child Health Nurse, School Health Nurse, Speech Pathology.

UY U

Tympanomeiry result normal Tympanometry result Type B = fluid in middle ear/otitis media! glue ear Type A Type © = Eustachian tube dysfunction

Le. +50 to -200 daPa =~“ tL ay!

Ear canal volume 0.5cc-1.5cc

Peak compliance 0.3mil-1.5ml Audiologist appointment — ‘GP appointment Referrer decides if child . needs review by GP. GP can refer to

NO FURTHER ACTION Child must be seen by ENT specialist and/or child may require

REQUIRED Audiologist prior to ENT treatment for ear condition. GP to use

appointment. Refer to audiclogy |) wACHS Community E-referral.

using CHIS referral (letters WACHS referral — child). Referral

to Dunsborough/Margaret River

If hearing loss, child referred Hearing: send referral to GS to Hearing Australia by J Population Health Clerical audiologist GSKt pophealthClerical@health. wa.gov.all

4

Discharge from audiology if er GS Pop Health Clerical enters audiology outcome into webP AS. Results into hospital

results aré within nonmnal file andfor CHIS. Audiologist refers client to ENT clinic with GP referral recommended. linnits:.

NO FURTHER ACTION ay

REQUIRED

Primary Health waitlsts clent on webPas.

u

ENT appointment Client attends ENT clinic.

U U

Tonsillectomy = referral to Perth Waitlsted for grommets and/or adenoid removal at Katanning Children’s Hospital. Health Service.

— Pre-admission Nurse to liaise with Waitlist Clerk, Theatre Manager and ENT specialist regarding dates for theatre + anaesthetist availability. Client must weigh = 20kgs.

GSAHS5 and Primary Health case meetings ‘uF every 4 months (following

ENT clinic).

Pre-admission nurse notifies administration of patient outcomes.

VY Vv

Administration makes appointment for post-surgery review with ENT for further monitoring.

COMMUNITY | COMPASSION | QUALITY | INTEGRITY EQUITY CURIOSITY

COMMUNITY COMPASSION QUALITY | INTEGRITY EQUITY | CURIOSITY