Highlights in child mental health research: February 2025

This month’s highlights include:

Culturally responsive interventions for autistic children and their families

This study conducted a meta-analysis to examine the effectiveness of culturally responsive interventions for autistic children and their families from culturally and racially diverse backgrounds, such as immigrant families. The paper examined 24 studies and found that culturally responsive interventions have a large and positive impact on autistic children’s social and communication skills and mental health. They also had a positive impact on parents’ mental health. The findings indicate that adapting programs to be culturally appropriate can lead to positive outcomes.

Sleep duration in adolescence buffers the impact of childhood trauma on anxiety and depressive symptoms

This study conducted an online survey of 752 adolescents on traumatic experiences and sleep duration, to examine the relationship between sleep, trauma, and anxiety and depressive symptoms. The study found that adolescents who had experienced trauma and received an adequate amount of sleep had lower anxiety and depressive symptoms than those with inadequate sleep and experiences of trauma. The study highlights the effects of childhood trauma on sleep and the importance of sleep for mental health.

Screen time among kindergarten children in the ACT

This study examined the relationship between screen time and health outcomes among First Nations children and non-Indigenous children in the Australian Capital Territory (ACT). The study used data from the ACT Kindergarten Health Check Survey on 5,516 children. The study found that more than two hours per day of screen time was associated with poor health outcomes for non-Indigenous children, but no association was found between screen time and health outcomes for First Nations children. They found most children in the ACT are meeting the guidelines of two hours of screen time per day for children aged 5-17 years.

Mental health help-seeking behaviours among children from diverse communities

This study examined emergency department presentations among children from culturally and linguistically diverse communities in Australia. The study used electronic medical reports from public health hospitals in New South Wales between 2016-2022. The study found children and young people from culturally and linguistically diverse communities are more likely to attend emergency departments for mental health reasons that other young people. Young people with intersecting risk factors, including being male or from a disadvantaged background, were more likely to attend for mental health reasons.

Why is this important?

• Interventions designed for autistic children and their families are often evaluated using groups of people with limited ethnic and cultural diversity (e.g. White, English-speaking, middleclass). This means that these interventions may not be well suited to culturally diverse families and their needs.
• A possible solution to this is to adapt and modify interventions to better fit with the cultural, linguistic, or social needs of a particular group. These are referred to as ‘culturally responsive’ interventions.

What did they do?

• This study conducted a meta-analysis (i.e. a type of statistical analysis that combines the results of multiple studies) that examined the evidence for the effectiveness of culturally responsive interventions for autistic children (0–18 years), and their families, from culturally and racially diverse backgrounds, such as immigrant families.
• The review included studies that were published in English and in peer reviewed academic journals and evaluated a culturally responsive intervention for autistic children or their family.

What did they find?

• The authors found 24 studies that met their inclusion criteria.
• This study found that culturally responsive interventions had a large and positive impact for autistic children’s social/communication skills and mental health. The interventions didn’t have a significant impact on child general development or autistic traits.
• Culturally responsive interventions also had a large and positive impact for parents’ mental health and how effectively they could implement the strategies from the intervention.

What does this mean for practice?

• Culturally responsive interventions have positive impacts for autistic children and their families who come from culturally and racially diverse backgrounds.
• When working with families from culturally and racially diverse backgrounds, the use of programs and interventions that have been adapted to their needs can lead to positive outcomes such as improved mental health.

Why is this important?

• Experiencing trauma in childhood can lead to poor mental health outcomes for adolescents.
• Experiences of trauma are associated with poor sleep. However, having an adequate amount of sleep can support healthy development and may protect against poor mental health.

What did they do?

• This study examined the impact of having an adequate amount of sleep on anxiety and depressive symptoms related to trauma experiences.
• A total of 752 adolescents (mean age 14 years) recruited from independent schools in Australia completed an online survey.
• An adequate amount of sleep was defined as 9–11 hours per night for those aged 13 years and younger, and 8-10 hours for those aged 14 years and older.

What did they find?

• The majority (82%) of adolescents in the sample had experienced at least one traumatic event in their life.
• Adolescents who had experienced a traumatic event had higher depressive and anxiety symptoms, lower mental wellbeing, and were less likely to be having an adequate amount of sleep compared to those who hadn’t experienced a traumatic event.
• Adolescents who had experienced trauma and who had an adequate amount of sleep had lower anxiety and depressive symptoms than those who were having inadequate sleep for their age range.

What does this mean for practice?

• This study highlights the importance of sleep for mental health, particularly in the context of trauma.
• For adolescents, experiencing a traumatic event is associated with poorer mental health and not having an adequate amount of sleep.
• Practitioners can be aware that not having enough sleep may exacerbate the effects of trauma on anxiety and depressive symptoms for adolescents.

Why is this important?

• High levels of screen time are associated with poor health outcomes for children, including being overweight/obesity, mental health challenges, developmental delays and respiratory problems.
• Many children in Australia exceed the recommended guidelines for screen time (no more than two hours per day for children aged 5–17 years).

What did they do?

• This study examined the association between screen time and health outcomes for First Nations and non-Indigenous children in the Australian Capital Territory (ACT).
• Data on 5,516 children (average age 5 years and 9 months) from the ACT Kindergarten Health Check (KHC) survey was analysed in the study. The KHC asks questions about the health of children in their first year of full-time primary education.

What did they find?

• The average daily screen time for First Nations and non-Indigenous children was 2.2 and 1.9 hours, respectively.
• More than two hours per day of screen time was associated poor health outcomes for non-Indigenous children, including being overweight/obesity, respiratory problems, developmental concerns, and reduced wellbeing.
• There were no association between screen time and health outcomes for First Nations children.

What does this mean for practice?

• In the ACT, most children’s screen time habits are consistent with guidelines.
• Non-Indigenous children who are on screens for more than the recommended two hours per day may have an increased risk of poor health outcomes.
• Practitioners can speak with children and families about the impact of excess screen time on child health, and encourage children who spend more than two hours per day on screens to reduce their screen time.

Why is this important?

• People from culturally and linguistically diverse communities have higher rates of mental health challenges than the general population.
• However, people from culturally and linguistically diverse communities use services, particularly mental health services, at low rates compared to their needs. This may be due to cultural beliefs, stigma and other structural barriers.
• Frequent use of emergency departments for health concerns best treated in the community, such as mental health, may suggest that people are facing barriers to accessing the primary health care services that they need.

What did they do?

• This study examined mental health related emergency department presentations among children and young people (aged <18 years) from culturally and linguistically diverse communities in Australia.
• The researchers analysed electronic medical records of emergency department presentations from six public health hospitals in New South Wales from 2016–2022.
• Mental health related emergency department presentations were categorised as high priority (triage needing to have treatment within 10 minutes) and low-to-moderate (needing to have treatment within 30–120 minutes).

What did they find?

• There were 8,135 emergency department presentations for mental health related reasons over the study period.
• The majority of presentations were low-to-moderate priority (92%) and 8% were high priority.
• Young people from culturally and linguistically diverse communities were more likely to present to an emergency department for high priority mental health reasons than young people who aren’t from culturally and linguistically diverse communities.
• The risk of emergency department presentation was higher for males from culturally and linguistically diverse communities and those from both from culturally and linguistically diverse and disadvantaged communities.

What does this mean for practice?

• Young people with intersecting risk factors, such as being from a culturally and linguistically diverse community, being male, and/or being from a disadvantaged background, are more likely to attend emergency departments for mental health related reasons.
• There is a need for more culturally responsive services and practitioners that can provide prevention and early intervention for mental health to reduce need for emergency care for mental health in culturally and linguistically diverse communities.