BACKGROUND Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers' concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. METHODS Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children < 8 years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents' Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. RESULTS Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8 years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62-3.61), being older (4.5 to < 8 years versus < 3 years old, 3.80, 2.21-6.54), prior history of ear infection (1.95, 1.21-3.15), having lived in 4 or more houses versus one house (4.13, 2.04-8.35), foster care versus living with a parent (5.45, 2.32-12.78), and having a caregiver with psychological distress (2.40, 1.37-4.20). CONCLUSION In SEARCH, 40% of urban Aboriginal children younger than 8 years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.

中文翻译：

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澳大利亚城市地区原住民儿童的发育风险：原住民适应力和儿童健康环境研究（SEARCH）。

背景技术大多数澳大利亚原住民儿童的发展步入正轨，但是，有发展或行为问题风险或有发展或行为问题的儿童的患病率高于其他儿童。原住民儿童发展数据主要来自偏远社区，而大多数原住民儿童居住在城市环境中。我们根据照顾者的关注程度，量化了处于中等和高发展风险的参与儿童的比例，并确定了与城市原住民社区发展风险相关的因素。方法研究方法是在2008年至2012年期间与澳大利亚新南威尔士州的四个参与项目的城市土著社区控制的卫生服务机构共同设计和实施的。照顾者报告的儿童数据< 通过访谈收集了参加纵向队列研究（原住民适应力和儿童健康环境研究：SEARCH）的8岁儿童。父母对发育状况的评估（PEDS）用于通过照顾者报告的方式评估发育风险。使用多项式Lo​​gistic回归计算赔率（OR），以调查风险因素并建立风险预测模型。结果725名接受PEDS数据搜索的儿童（占合格的69％）中，有405名（56％）是男性，有336名（46％）年龄在4.5至8岁之间。使用PEDS时，高风险者占32％，中度风险者占28％，低/无发育风险者占40％。与低风险/无风险相比，在相互调整的模型中，与较高的发展风险相关的因素是研究对象，并且需要针对研究地点进行额外的调整，其中男性为OR（OR 2.42，95％置信区间1.62-3.61），年龄较大（4.5至<8岁，小于3岁，分别为3.80、2.21-6.54），有耳部感染的既往病史（1.95、1.21-3.15），相对于一所房屋住了4个或更多房屋（4.13、2.04-8.35） ），寄养与父母住在一起（5.45，2.32-12.78），以及有心理困扰的看护人（2.40，1.37-4.20）。结论在搜索中，有40％的8岁以下的城市原住民儿童没有发育风险或发育风险低。与较高的发展风险相关的几个因素是可以修改的。需要原住民社区推动的计划，以改善对发展问题的发现并促进早期干预。养育照顾与与父母同住（5.45，2.32-12.78）以及照顾有心理困扰的照顾者（2.40，1.37-4.20）。结论在搜索中，有40％的8岁以下的城市原住民儿童没有发育风险或发育风险低。与较高的发展风险相关的几个因素是可以修改的。需要原住民社区推动的计划，以改善对发展问题的发现并促进早期干预。养育照顾与与父母同住（5.45，2.32-12.78）以及照顾有心理困扰的照顾者（2.40，1.37-4.20）。结论在搜索中，有40％的8岁以下的城市原住民儿童没有发育风险或发育风险低。与较高的发展风险相关的几个因素是可以修改的。需要原住民社区推动的计划，以改善对发展问题的发现并促进早期干预。