Children with additional health and developmental needs (AHDN) are those who have or are at risk of being diagnosed with a chronic condition, and as a result need more supports than their peers. This can include physical, developmental, behavioural, or emotional difficulties.
Research suggests that 1 in 5 children entering school have AHDN, and this can have a profound impact on their school experiences. For example, children can miss more school, have trouble doing school work because of fatigue or problems learning, and feel left out from peers and school life.
In Australia, children with AHDN are overrepresented in the most disadvantaged settings. When children have both AHDN and are disadvantaged, the effect on their learning can compound. This is because children with AHDN are most in need of resources like high quality schools. Yet disadvantaged children have lower access to these resources.
Both schools and the health system have an important role to play in supporting children with AHDN to reach their full potential. Planning appropriate services and supports relies on having accurate data about AHDN.
We need to know:
This study used data from the Australian Early Development Census (AEDC; www.aedc.gov.au) to examine the proportion of children with AHDN in 2009, 2012, and 2015. This was examined for both overall AHDN and specific areas of impairment. We also examined whether children living in disadvantaged areas were more likely to experience AHDN in each year.
For the AEDC, teachers of children in their first year of school assessed each child in their class and answered around 100 questions across five areas of early childhood development, completed in 2009, 2012 and 2015. The number of children increased in each year: 261,147 in 2009, 289,973 in 2012, and 302,003 in 2015.
Teachers report on children’s AHDN in the AEDC. Children with formally diagnosed special needs were categorised as having established needs. Children with milder or undiagnosed problems were classified as having emerging needs.
Overall, the proportion of children with emerging needs and established needs in each year was very similar (Figure 1). Emerging needs decreased 0.9% from 18% to 17.1% between 2009 and 2015, while established needs increased 0.3% from 4.4% to 4.7%. Even though the proportions are relatively stable, more children started school with AHDN in 2015. This is because the total population of children is increasing over time. This means that in 2015 there were 4,778 more children starting school with emerging needs, and 2,581 more children starting school with established needs, than in 2009.
Over this period there were some substantial changes in the types of difficulties that children were experiencing
(Figure 2). For children with emerging needs, the largest increases were seen in:
- speech impairment (14.7%)
- emotional problems (7.0%), and
- learning disability (5.3%).O
For established needs, the largest increases were seen for:
- emotional problems (by 13.7%)
- behavioural problems (by 7.1%), and
- speech impairment (by 6.1%).
Figure 3 shows the proportion of children with AHDN according to the level of disadvantage in their community.
Children living in disadvantaged communities had higher levels of AHDN. These differences were found in each year,
and for both emerging needs and established needs.
The results show that a large proportion of children starting school each year have AHDN. Because the population is growing, this translates to a higher number of children. This means that there are more children starting school with AHDN each year across Australia.
In addition children have increasingly complex difficulties like language, learning and emotional problems.The number of children with AHDN continues to be concentrated in more disadvantaged areas, potentially leading to an increasing burden on schools.
Making a difference to the health and learning outcomes of children with AHDN requires a greater focus on support during the early school years. After this time it becomes much harder to shift learning outcomes. This requires coordinated support that is responsive to the child’s individual needs.For some children there is the combined impact of having AHDN and living in a disadvantaged community. A focus on promoting early development is key, so that inequities are not already becoming entrenched by school entry. Funding structures should take into account emerging needs and the impact of disadvantage, so that schools are adequately resourced to support children.
Greater attention needs to be given to ensuring that children with AHDN are effectively supported during the early school years. This will require the combined efforts of both the education and health systems.
For further details
Details of the research paper
For full technical details of this research see: O’Connor, M., O’Connor, E., Quach, J., Vashishtha, R., & Goldfeld, S.(In preparation). Trends in the prevalence of special health care needs from 2009 to 2015.
A full list of references used in the development of this snapshot is available online with this link
About research snapshots
Research Snapshots provide a brief and accessible overview of research being undertaken in relation to
the AEDC. This project was funded by the Australian Government under the AEDC program. For further
information and resources consult the AEDC website: www.aedc.gov.au.
About the organisation
The Centre for Community Child Health (CCCH) has been at the forefront of Australian research into early childhood and behaviour for over two decades.The CCCH conducts research into many conditions and common problems faced by children that are either preventable or can be improved if recognised and managed early. By working collaboratively with leaders in policy, research, education and service delivery, the Centre aims to influence early childhood policy and improve the capacity of communities to meet the needs of children and their families. CCCH is a department of The Royal Children’s Hospital and a research group of the Murdoch Childrens Research