NSW-CDS Publications

  • Green, M.J., Kariuki, M., Dean, K., Laurens, K.R., Tzoumakis, S., Harris, F., Carr, V.J. (2017). Childhood developmental vulnerabilities associated with early life exposure to infectious and noninfectious diseases and maternal mental illness. Journal of Child Psychology and Psychiatry; doi: 10.1111/jcpp.12856 (Published online 26 December 2017). 

     This study investigated the effects of in utero exposure to maternal infection and noninfectious diseases during pregnancy on offspring developmental vulnerabilities at age 5 years, in a population sample of 66,045 children drawn from the NSW Child Development Study (NSW-CDS) cohort. Maternal infectious diseases during pregnancy and early childhood infection conferred the largest associations with developmental vulnerabilities at age 5 years; maternal noninfectious illness during pregnancy also retained small but significant associations with developmental vulnerabilities even when adjusted for other physical and mental illness exposures and covariates known to be associated with early childhood development. Among all exposures examined, maternal mental illness first diagnosed prior to childbirth conferred the greatest odds of developmental vulnerability at age 5 years.  Prenatal exposure to infectious or noninfectious diseases appear to influence early childhood physical, social, emotional and cognitive developmental vulnerabilities that may represent intermediate phenotypes for subsequent mental disorders.

  • Green, M.J., Tzoumakis, S., Laurens, K.R., Dean, K., Kariuki, M., Harris, F., O’Reilly, N., Chilvers, M., Brinkman, S.A., Carr, V.J. (2017). Latent profiles of early developmental vulnerabilities in a NSW child population at age 5 years. Australian & New Zealand Journal of Psychiatry; doi: 10.1177/0004867417740208 (Published online 6 November 2017).

This study determined classes of children among the general population who may be at risk for later mental disorder on the basis of early patterns of developmental functioning, and the associations of each risk-class with exposure to childhood maltreatment, parental mental illness, parental offending, and perinatal adversities, and other demographic factors. Data from 16 subdomains of the Australian Early Development Census (AEDC) were used to determine classes of children with shared patterns of developmental vulnerabilities in a population sample of 67,353 children drawn from the New South Wales Child Development Study (NSW-CDS) cohort. Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ (6.5%); (2) ‘pervasive risk’ (4.0%); (3) ‘mild generalised risk’ (11.6%); and (4) ‘no risk’ (77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage, and perinatal adversities.

  • Green, M.J., Tzoumakis, S., McIntyre, B., Kariuki, M., Laurens, K.R., Dean, K., Chilvers, M., Harris, F., Butler, M., Brinkman, S.A., Carr, V.J. (2017). Childhood maltreatment and early developmental vulnerabilities at age 5 years. Child Development, Aug 2017. doi: 10.1111/cdev.12928. 


The study focused on the effects of early life maltreatment on early childhood developmental outcomes, including examination of the effects of multiple maltreatment types and developmental maltreatment timing, in a large population sample. We specifically examined associations between the type, and timing, of childhood maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (34,562 males) drawn from the New South Wales Child Development Study (NSW-CDS) cohort, using linked administrative data for children and their parents (collected from 2001-2009). The mean age of the child sample was 5.62 years (SD=0.37), and 2,135 children had already been exposed to (substantiated) maltreatment according to child protection records. Exposure to any type of childhood maltreatment was associated with pervasive developmental vulnerability at age 5 years. Children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple developmental domains relative to non-maltreated children. These patterns of association were found in the context of other important risk factors for early childhood developmental vulnerabilities that have been implicated in previous studies (e.g., male sex, maternal smoking during pregnancy).

  • Laurens K.R., Tzoumakis S., Dean K., Brinkman S.A., Bore, M., Lenroot, R.K., Smith, M., Holbrook, A., Robinson K.M., Stevens, R., Harris, F., Carr, V.J., Green, M.J (2017). The 2015 Middle Childhood Survey (MCS) of mental health and well-being at age 11 years in an Australian population cohort. BMJ Open 2017;7:e016244. doi:10.1136/bmjopen-2017-016244. 

This report provides a description of responses to the Middle Childhood Survey (MCS), a computerised self-report assessment of children’s mental health and well-being completed by 27 808 children aged 11-12 years in New South Wales (NSW) schools in 2015. The MCS sample includes 85.9% of students enrolled at the 829 schools who participated in the MCS (35% of eligible schools in NSW), and these participating schools and children are representative of the NSW population. The MCS measured Social Integration, Prosocial Behaviour, Peer Relationship Problems, Supportive Relationships (at Home, School and in the Community), Empathy, Emotional Symptoms, Conduct Problems, Aggression, Attention, Inhibitory Control, Hyperactivity-Inattention, Total Difficulties (internalising and externalising psychopathology), Perceptual Sensitivity, Psychotic-Like Experiences, Personality, Self-esteem, Daytime Sleepiness and Connection to Nature. This report presents response distributions on each of these indices, indicating the range of competencies and vulnerabilities in the population.

  • Tzoumakis, S, Dean, K, Green, MJ, Zheng, C, Kariuki, M, Harris, F, Carr, VJ, & Laurens, KR. The impact of parental offending on offspring aggression in early childhood: A population-based record linkage study. Soc Psychiatry Psychiatr Epidemiol, 2017, 54(4), 445-455. Published online 13 January 2017: doi: 10.1007/s00127-017-1347-3   

This study examined the impact of parental criminal offending, both paternal and maternal, on offspring aggression at age 5 years. Parental mental illness, child’s sex, and socioeconomic disadvantage were also accounted for in the analyses. Offspring aggression was assessed using the Aggressive Behaviour subdomain of the Australian Early Development Census (AEDC), a teacher-reported cross-sectional survey on child development. Parental criminal offending was obtained from NSW Bureau of Crime Statistics data and parental mental health was obtained from NSW Admitted Patients and Mental Health Ambulatory data. Parental history of violent and frequent offending increased the risk of high levels of aggression in offspring during early childhood, highlighting the need for intervention with families during this key developmental period.

  • Laurens, K.R., Tzoumakis, S., Kariuki, M., Green, M.J., Hamde, M., Harris, F., Carr, V.J., Dean, K. (2017). Pervasive influence of maternal and paternal criminal offending on early childhood development: A population data linkage study. Psychological Medicine, 47(5), 889-901.

This report examined the impact of parental criminal offending on developmental outcomes at age 5 years. Data from the Australian Early Development Census, a teacher-reported assessment of childhood development across five key domains, was linked with maternal and paternal offending histories obtained from official records. Children whose parents had a history of criminal offending were at significantly greater risk of developmental vulnerability on each of the five domains. The risk of vulnerability increased further when both parents offended, when mothers rather than fathers offended, and when the offending was of a violent nature. For all types of offending, children were more likely to be vulnerable on multiple domains than on a single domain. These findings indicate a widespread impact of parental offending on early childhood development and highlight the need to support affected families in order to improve outcomes.

  • Carr, V.J., Harris, F., Raudino, A., Luo, L., Kariuki, M., Liu, E., Tzoumakis, S., Smith, M., Holbrook, A., Bore, M., Brinkman, S.A., Lenroot, R.K., Dix, K., Dean, K., Laurens, K.R., Green, M.J. (2016). Cohort Profile: The New South Wales Child Development Study (NSW-CDS) – An Australian multi-agency, multi-generational, longitudinal record linkage study. BMJ Open, 6:e009023 doi:10.1136/bmjopen-2015-009023.

This report provides a description of the characteristics of children who make up the NSW Child Development Study cohort. This group comprises 87,000 children who commenced their formal school education in 2009, and for whom class teachers completed the Australian Early Development Census (AEDC). Rates for the successful linkage of the AEDC records with other administrative data for the children and their parents are provided within this publication, and information about the demographic characteristics (e.g., sex, geographic and socioeconomic distributions), as well as the representativeness of this group to a comparable national population. The strengths and limitations of the study are also discussed.

  • Kariuki, M., Raudino, A., Green, M.J., Laurens, K.R., Dean, K., Brinkman, S.A., Lenroot, R.K, Liu, E., Harris, F., Luo, L., Carr, V.J. (2016). Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years. Journal of Paediatrics and Child Health, 52(9), 882-888. (Abstract)

This study examined the relationship between early childhood infections requiring hospitalisation and developmental vulnerability at age 5 years, as assessed using the Australian Early Development Census (AEDC). The AEDC provides an index of each child’s level of function on five domains, including Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills, Communication Skills and General Knowledge. Hospital admissions for infections were associated with vulnerability on all five developmental domains. This suggests that severe infections during early childhood may pose a risk to development by school-age.

  • Matheson, S.L., Kariuki, M., Harris, F., Green, M.J., Tarren-Sweeney, M., Dean, K., Tzoumakis, S., Brinkman, S., Chilvers, M., Sprague, T., Carr, V.J., Laurens, K.R. (2016). Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study. Epidemiology and Psychiatric Sciences. doi: 10.1017/S204579601600055X

This study examined the associations between early childhood maltreatment (age 0-5 years) and childhood social and emotional functioning at approximately age 5 years. This was achieved by linking Family and Community Services Data, parental Mental Health Ambulatory and Admitted Patients Data and Australian Early Development Census Data.  Medium-sized associations were found between maltreatment and poor social competency, aggressive behaviour, and hyperactive/inattentive behaviour, and small associations were found between maltreatment and poor prosocial/helping and anxious/fearful behaviour. These results suggest childhood maltreatment may adversely impact on early childhood social and emotional functioning.

  • Laurens, K.R., Luo, L., Matheson, S.L., Carr, V.J., Raudino, A., Harris, F., Green, M.J. (2015). Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry.

This scientific review provides a summary of the available evidence relating to risk factors for the development of schizophrenia spectrum disorders (e.g., schizophrenia, schizoaffective disorder), and affective psychoses (e.g., bipolar disorder). A total of 127 papers were reviewed for the purpose of evaluating the evidence for various risk factors as potentially conferring risk for psychoses, and to highlight gaps in the evidence base.  Factors which conferred the greatest risk, or were observed most consistently to confer risk to both affective and non-affective (schizophrenia spectrum) psychoses, included: obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions.

  • Sara, G., Luo, L., Carr, V.J., Raudino, A., Green, M.J., Laurens, K.L., Dean, K., Cohen, M. Burgess, P., Morgan, V.A. (2014). Comparing algorithms for deriving psychosis diagnoses from longitudinal administrative clinical records. Social Psychiatry and Psychiatric Epidemiology, 49(11), 1729-37. (Abstract)

This study describes a method that we have tested to determine the performance of four different methods for assigning a single diagnosis (for a psychotic disorder) from health records in which multiple diagnoses can be recorded for a single individual over time. Administrative health records are valuable research tools but the methods to extract accurate mental health diagnoses can be challenging because of the number of admissions for any given individual. The methods tested in this report include testing the validity of using: ‘any’ diagnosis, ‘most recent’ diagnosis, ‘most frequent’ (modal) diagnosis or ‘hierarchy’ (where a diagnostic hierarchy was applied). Overall agreement between administrative and reference diagnoses was modest with different methods producing results of varying accuracy. This illustrates that the choice of methods used to summarise health records can impact the accuracy of diagnosis and hence is an important consideration for study methods.


  • Moore, E.A., Harris, F., Laurens, K.R., Green, M.J., Brinkman, S., Lenroot, R.K., Carr, V.J. (2014). Birth outcomes and academic achievement in childhood: A population record linkage study. Journal of Early Childhood Research, 12(3), 234–250. (Abstract)

This scientific report examined the association between early life risk factors and academic achievement at Kindergarten (approx. age 5) and Grade 3 (approx. age 8). This was achieved by linking the NSW Midwives data collection with the Best Start Kindergarten Assessment and NAPLAN results. Increasing maternal age and lack of maternal prenatal smoking were associated with improved academic performance. The results suggest that programs that target children with less developed academic skills during the first year of school may improve subsequent results.


 Other Relevant Research 

Jones, D. E., Greenberg, M. & Crowley, M. (2015). Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. American Journal of Public Health, 105(11), 2283-2290.

An interesting study finding that teacher rated prosocial skills in Kindergarten were related to outcomes in adolescence and young adulthood. Consistent results among student self-report, parent & teacher reports and court records, indicated that greater prosocial skills significantly predicted more positive education and employment outcomes, and fewer interactions with the criminal justice system. 

Newton-Howes, G., Horwood, J., & Mulder, R. (2015). Personality characteristics in childhood and outcomes in adulthood: Findings from a 30-Year longitudinal study. Australian & New Zealand Journal of Psychiatry, 49(4), 377-386.

This journal article reports findings about neuroticism and extraversion, as predictors of social and wellbeing outcomes in adulthood. Look out for more personality research using the Big 5 Questionnaire for Children coming soon.

Brinkman, S., Gregory, T. A., Goldfeld, S., Lynch, J. W., & Hardy, M. (2014). Data resource profile: The Australian Early Development Index (AEDI).  International Journal of Epidemiology, 43(4), 1089-1096.

This article outlines the use of the Australian Early Development Index as a resource for collecting population-level data of Australian children.

Brinkman, Gregory, T., Harris, J., Hart, B., Blackmore, S., & Janus, M. (2013). Associations between the Early Developmental Instrument (EDI) at age 5, and reading and numeracy skills at ages 8, 10, and 12: A prospective linked data study. Child Indicators Research, 6(4), 695-708.

This paper reports results from the first Australian study to explore the relationship between the EDI and national standard school assessments. Developmental vulnerabilities on 1 or more EDI domain predicts students' Literacy and Numeracy results, as assessed by the Western Australian Literacy and Numeracy (WALNA) in Year 3 and the National Assessment Program Literacy and Numeracy (NAPLAN) in Years 5 and 7. 

Curtin, M., Madden, J., Staines, A., & Perry, I. (2013). Determinants of vulnerability in early childhood development in Ireland: A cross-sectional study. BMJ Open, 3(5).

This journal article explores the use of the EDI to indicate the extent, distribution and determining factors of childhood vulnerabilities in Ireland. Results indicate that males, children under 5, and children having English as a second language (ESL) are at greater risk of being developmentally vulnerable upon entering full-time schooling.