Dissertations / Theses on the topic 'Aboriginal Australian Children'

This longitudinal research explored the use of Aboriginal English (AE) dialect by Australian Aboriginal preschool children. Data from educator-child interactions was analysed for features of AE and change in dialect density across contexts. Interview data gathered from educators and carers about the children’s communicative competency was analysed qualitatively. Results confirmed Aboriginal children’s use of AE dialect and highlighted factors perceived by participants to affect their language and literacy development. Directions for future research are indicated.

Undernutrition in prevalent in Aboriginal communities, in utero, infancy and childhood. It influences childhood morbidity and mortality and growth patterns. Undernutrition and poor socio-economic status also contribute to endemic and epidemic infectious disease, including scabies and streptococcal infection. It has been suggested that early undernutrition, and streptococcal and scabies infection are risk factors for renal disease, which is at epidemic levels and increasing. This thesis examines the prevalence of undernutrition in newborns and infants in an Aboriginal community over time, and its impact on childhood growth and child and adult renal markers. The association between skin lesions, streptococcal serology, post-streptococcal glomerulonephritis (PSGN) and renal markers as evaluated through a community wide screening program in 1992-1995 is also examined. Birthweights have increased since the 1960s, but they are still much lower than the non-Aboriginal values. Weights in infancy have decreased since the 1960s. At screening in childhood stunting was common, reflecting the presence of long-term poor nutrition in infancy. In both adults and children, birth weight and infant weights were negatively associated with albuminuria measured by the albumin to creatine ratio (ACR).

While prejudice against Aboriginal-Australian people in Perth is well documented (e.g., Pedersen & Walker, 1997), no research exists as to whether Aboriginal children feel this prejudice, and if so whether it relates to their sense of self. The present project examines these issues. Its major emphasis is the self-attitudes of urban Aboriginal-Australian children (primarily local Nyoongah) and - to a lesser degree - Anglo­Australian children, both at a group and personal level. More specifically, the project examines the children's ingroup preference (i.e., how they feel about their cultural group) and their self-concept (i.e., how they feel about themselves personally), and the relationship between the two constructs. Also of interest is the effect of culture of interviewer on such self-attitudes, the relationship between the children's self-attitudes and reflected appraisals (how the children feel others like them), and the relationship between the children's self­attitudes and their teachers' ratings of their academic performance. Chapter One gives a brief introduction to the topic, and Chapters Two and Three examine the research relating to ingroup preference and self-concept/ self-esteem. Chapter Four outlines the issues relating to the testing of Aboriginal children, and details three pilot studies. Within this chapter, Study One examines what facets of self are important to both Aboriginal and Anglo children. Studies Two and Three pilot-test the ingroup preference and self-concept scales. Chapters Five and Six present the main studies. The main focus of Chapter Five (Study Four) is to investigate the ingroup preference of Aboriginal children, and the relationship between ingroup preference and self-concept. The study (ii) particularly focuses on the effects of interviewer culture (Aboriginal versus Anglo) on the children's responses. 117 Aboriginal children aged 5-12 years were interviewed about their ingroup preference. Children aged eight and over were also interviewed about their selfconcept and reflected appraisals. Children under eight years of age were not interviewed due to controversy in the literature about testing very young children in this respect. The children showed greater ingroup preference when interviewed by an Aboriginal interviewer; no such effect was found with self-concept scores. While age had no significant effect on ingroup preference, a negative correlation existed between age and self-concept. Self-concept scores were significantly more positive than, and were unrelated to, ingroup preference scores. In general, the Aboriginal children demonstrated awareness of specific cultural stereotypes at an early age. With respect to the reflected appraisals questions, results differed depending upon the interviewer. Using data from the Aboriginal interviewer, results indicated that almost half the children felt that the wider community didn't like them, with boys in the older age bracket feeling this more than girls of the same age. Reflected appraisals items were more strongly related to self-concept rather than ingroup preference measures; in addition, family influences on self-concept scores were on the whole stronger than societal ones. It was concluded that family support buffers Aboriginal children to a degree from the attitudes of the wider community. In Chapter Six, the final study is described and discussed. This involved testing the ingroup preference of 60 Aboriginal and 60 Anglo (iii) children aged 6-12 years. As in Study Four, children aged eight and above were also interviewed about their self-concept and reflected appraisals. These variables were then linked with teachers' ratings of academic performance. Results indicated that Anglo children showed greater ingroup preference and scored higher on teacher appraisals than Aboriginal children, although there was no difference on self-concept. Complex relationships were also found between reflected appraisals and the other variables that differed depending upon the culture of child. Seven major findings emerged from this project. First, both Aboriginal and Anglo children demonstrated awareness of specific social stereotypes of Aboriginal and Anglo people at a very early age. This led to Aboriginal children scoring lower on ingroup preference than Anglo children. However, responses of the children were extremely heterogeneous. Second, both Aboriginal and Anglo children scored high on self-concept scores, which supports the majority of previous research that minority groups do not necessarily score lower in this regard. Third, Aboriginal children scored higher on ingroup preference with a same-culture interviewer than with an Anglo- Australian interviewer. Fourth, how the children felt about themselves personally was unrelated to their ingroup preference in all studies. Fifth, regarding reflected appraisals, family influences on ingroup preference and self-concept scores were on the whole stronger than societal ones. Sixth, in Study Four, almost half the Aboriginal children (especially the older boys) felt that the wider community didn't like (iv) them. Finally, Aboriginal children scored lower than Anglo children on academic performance. The overall conclusion reached in this project is that the problems faced by Aboriginal children are only likely to be alleviated by a great deal of structural change, as cultural oppressions are perpetuated by societal rules. A good place to start is within the school system itself, which in some respects reflects the societal system at large.

Thesis (Ph.D.)--University of Wollongong, 2007.
"Including the plays Positive expectations and Waiting for ships." Title from web document (viewed 7/4/08). Includes bibliographical references: leaf 249-267.

Thesis (Ph.D.)--University of Western Sydney, 2001.
"A thesis presented to the University of Western Sydney in partial fulfilment of the requirements for the degree of Doctor of Philosophy". Bibliography : p. 224-240.

This thesis is a seminal in-depth study of how non-indigenous writers and illustrators construct Aboriginal childhood in children's fiction from 1841-1998 and focuses not only on what these say about Aboriginal childhood but also what they neglect to say, what they gloss over and what they elide. This study probes not only the construction of aboriginal childhood in children's fiction, but explores the slippage between the lived and imagined experiences which inform the textual and illustrative images of non-Aboriginal writers. This study further contends that neo-colonial variations on the themes informing these images remain part of Australian children's fiction. Aboriginal childhood has played a limited but telling role in Australian children's literature. The very lack of attention to Aboriginal children in Australian children's fiction - white silence - is resonant with denial and self-justification. Although it concentrates on constructions of aboriginal childhood in white Australian children's fiction, this study highlights the role that racial imagery can play in any society, past or present by securing the unwitting allegiance of the young to values and institutions threatened by the forces of change. By examining the image of the Other through four broad thematic bands or myths - the Aboriginal child as the primitive; the identification of the marginalised and as the assimilated and noting the essential similarities that circulate among the chosen texts, this study attempts to reveal how pervasive and controlling the logic of racial and national superiority continues to be. By exploring the dissemination of images of Aboriginal childhood in this way, this study argues that long-lived distortions and misconceptions will become clearer

National measures of achievement among Australian school children suggest that Aboriginal students, considered as a group, are those most likely to end their schooling without achieving minimal acceptable levels of literacy and numeracy. In view of the fact that many Aboriginal students dwell in metropolitan areas and speak English as a first language, many educators have been unconvinced that linguistic and cultural difference have been significant factors in this underachievement. This study explores the possibility that, despite intensive exposure to non-Aboriginal society, Aboriginal students in metropolitan Perth may maintain, through a distinctive variety of English, distinctive conceptualisation which may help to account for their lack of success in education. The study first develops a model of conceptualisations that emerge at the group level of cognition. The model draws on the notion of distributed representation to depict what are here termed cultural conceptualisations. Cultural conceptualisations are conceptual structures such as schemas and categories that members of a cultural group draw on in approaching experience. The study employs this model with regard to Aboriginal and non-Aboriginal students attending schools in the Perth Metropolitan area. A group of 30 Aboriginal primary school students and a matching group of non-Aboriginal students participated in this study. A research technique called Association-Interpretation was developed to tap into cultural conceptualisations across the two groups of participants. The technique was composed of two phases: a) the 'association' phase, in which the participants gave associative responses to a list of 30 everyday words such as 'home' and 'family', and b) the 'interpretation' phase, in which the responses were interpreted from an ethnic viewpoint and compared within and between the two groups. The informants participated in the task individually. The analysis of the data provided evidence for the operation of two distinct, but overlapping, conceptual systems among the two cultural groups studied. The two systems are integrally related to the dialects spoken by Aboriginal and non-Aboriginal Australians, that is, Aboriginal English and Australian English. The discrepancies between the two systems largely appear to be rooted in the cultural systems which give rise to the two dialects while the overlap between the two conceptual systems appears to arise from several phenomena such as experience in similar physical environments and access to 'modem' life style. A number of responses from non-Aboriginal informants suggest a case of what may be termed conceptual seepage, or a permeation of conceptualisation from one group to another due to contact. It is argued, in the light of the data from this study, that the notions of dialect and 'code-switching' need to be revisited in that their characterisation has traditionally ignored the level of conceptualisation. It is also suggested that the results of this study have implications for the professional preparation of educators dealing with Aboriginal students.

This thesis is a history of schooling for Indigenous children in Western Australia between the commencement of the first Aboriginal school in Perth in 1840 and 1978. The thesis represents the view that, for most of this period, and regardless of policy, education for Indigenous children was directed towards changing their beliefs and behaviours from being distinctly Aboriginal to recognizably European. Four major policies for Aborigines provide the framework for the thesis, these being amalgamation (1840-1852), protection (1886-1951), assimilation (1951-1972) and self-determination (1973- ). The amalgamation of the Indigenous popuIation with the small colonial society in Western Australia was a short-lived policy adopted by the British Colonial Office. Protection, a policy formalised by Western Australian legislation in 1886, 1905 and 1936, dominated Aboriginal affairs for the first half of the 2ofh century. Under this policy the Indigenous population was regarded as two distinct groups - a diminishing traditional population to be segregated and protected and an increasing part-Aboriginal population that was to be trained and made 'useful'. In 1951 Western Australia accepted a policy of assimilation, coordinated by the Commonwealth government, which anticipated that all people of Aboriginal descent would eventually be assimilated into the mainstream Australian society. This policy was replaced in 1973 by one of Aboriginal community self-determination, an initiative of the Commonwealth government and adopted throughout Australia. The attempts at directed cultural change were evident in the 'Native' schools that opened in Perth, Fremantle and Guildford in the 1840s where it was assumed that the separation of children from their families and a Christian education would achieve the transition from a 'savage to civilized' state. For another century the education of Indigenous children on missions and in government settlements was founded upon similar assumptions. The thesis acknowledges that the principal change agents, such as the Chief Protectors of Aborigines, mission administrators and the teachers in direct contact with the children, seriously underestimated both the enduring nature of Indigenous culture and the prejudice in Australian society. Between 1912 and 1941 a few government schools in the southern districts of Western Australia refused to admit Aboriginal children. The exclusion of these children is examined against a background of impoverished living conditions, restrictive legislation and mounting public pressure on the State and Commonwealth governments for a change in policy. The change did not begin to occur until 1951 when the Commonwealth and States agreed to a policy of assimilation. In Western Australia this policy extended education to all Aboriginal children. The thesis explores the provision of government teachers to Aboriginal schools in remote areas of Western Australia between 1951 and 1978. The final chapter examines Indigenous perceptions of independent community schools within the fust five years of the policy of self-determination and contrasts the objectives and management of two schools, Strelley in the Pilbara and Oombulguni in the Kimberley.

Thesis (Ph.D.) -- La Trobe University, 2006.
Research. "A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy, La Trobe Law, Faculty of Law and Management, La Trobe University, Bundoora, Victoria". Includes bibliographical references (leaves 318-338). Also available via the World Wide Web.

This research presents the first comprehensive analysis of the vision and ocular characteristics of Australian Indigenous children including the prevalence of vision condition such as refractive error, and assessment of macula retinal thickness, optic nerve head dimensions, and ocular biometry. Findings revealed important differences in the process of emmetropisation, and in several ocular structures which may impact the risk for and detection of ocular diseases in adulthood. Additionally, while Indigenous and non-Indigenous children exhibited similar rates of vision conditions, Indigenous children were less likely to have received an eye examination, highlighting the importance of improved eyecare services for Indigenous Australians.

[Truncated abstract. Please see pdf format for complete text.] Background : The excess burden of mortality born by young Indigenous Australians and the disparity in infant and childhood mortality between Indigenous and non-Indigenous Australians have been well documented. The accuracy and completeness of national data describing the health of Indigenous Australians is inconsistent. The Western Australia (WA) Maternal and Child Health Research Database (MCHRDB), is a linked total population database that includes perinatal maternal and infant data, and infant and childhood morbidity and mortality data. Overall, these data are more than 99% complete, with a similar high level of completeness and validity for Indigenous Western Australians. Aim : The aim of this thesis is to measure Indigenous infant (0 to <1 year) and childhood (>=1 to <19 years) mortality and the disparity between Indigenous and non-Indigenous infants and children in WA for birth cohorts from 1980 to 1997 inclusive. To achieve this aim a number of secondary aims were identified, including the measurement of certain maternal and infant variables, and the age-specific, all-cause and cause-specific mortality for WA infants and children. Method : The study comprises a longitudinal birth cohort study, the primary data source being the MCHRDB. Data included on the MCHRDB are complete for all births in WA from 1980 onwards, with new birth cohorts linked on an annual basis. Maternal and infant variables and the geographical location of the residence and the time of birth and death were included in the descriptive and multivariate analyses. Each infant and childhood death was coded using a three-digit code developed primarily for research purposes. The descriptive analyses of mortality referred to the probability of dying in infancy and in childhood as the cumulative mortality risk (CMR), for various diseases and various population subgroups. Age-specific childhood rates were also calculated. The results of multivariate analyses included the fitting of Cox and Poisson regression models, and estimates of effect were represented as hazard ratios (Cox regression) and relative rates (Poisson regression). Results : Between 1980 and 1997, births to Indigenous mothers accounted for 6% of total WA births. Approximately 46% of Indigenous births were to mothers living in a remote location compared to 9% of non-Indigenous births. Indigenous mothers gave birth at an earlier age (30% of births were to teenage mothers compared to 6% of non-Indigenous births), and were more likely to be single than non-Indigenous mothers (40% Indigenous, 9% non-Indigenous). Indigenous infants had more siblings, were born at an earlier gestation and with a lower birth weight and percentage of expected birth weight. The CMR for Indigenous infants was 22 per 1000 live births compared with 6.7 for non- Indigenous infants, a relative risk (RR) of 3.3 (95%CI 3.0, 3.6). While there was a decrease in the CMR over the birth year groups for both populations, the disparity between the rate of Indigenous and non-Indigenous infant mortality increased. The Indigenous postneonatal (>28 to 365 days) mortality rate (11.7 per 1,000 neonatal survivors) was higher than the neonatal (0 to 28 days) mortality rate (10.3 per 1,000 live births). This profile differed from that for non-Indigenous infants, where the neonatal mortality rate (4.3 per 1,000 live births) was nearly twice that of the postneonatal mortality rate (2.4 per 1,000 neonatal survivors). The main causes of infant mortality among Indigenous infants were potentially preventable. These causes were infection followed by Sudden Infant Death Syndrome (SIDS), which differed from the main causes for non-Indigenous infants, sequelae of prematurity and birth defects. The CMR attributable to SIDS increased over the years amongst Indigenous infants and decreased significantly over the years in the non-Indigenous population. Furthermore, the disparity in mortality between the two populations increased and, in 1995 to 1997, was over seven times higher amongst Indigenous infants. The CMR was highest amongst infants living in remote locations for all causes of death except for Indigenous deaths attributable to SIDS, where the risk of death was highest amongst infants living in metropolitan locations. With the exception of infection, there was no difference in cause-specific mortality amongst Indigenous infants according to geographical location. Indigenous infants living in a remote location were at a significantly increased risk of death due to infection compared with their peers living in a rural or metropolitan location. The risk of death for Indigenous children was more than three times higher than for non-Indigenous children. This risk was significantly increased when most of the perinatal maternal and infant variables were considered.

This study constructed contemporary radiographic bone age estimation standards for the Queensland paediatric population through a morphological and morphometric analysis of the ossification of the hand and wrist. A digital application is introduced and recommended as an alternative to traditional techniques to improve the accuracy of maturational assessment in a multi-ancestral population. These standards will improve the reliability of bone age estimation in clinical and forensic applications.

This thesis is a study of students’ experiences as learners of Standard Australian English (SAE) as an additional language or dialect in early years classrooms in an Australian Aboriginal community. It takes as its starting point reports that English‐lexified varieties spoken in many Aboriginal communities are not explicitly recognised as systematically different from SAE within the formal education system. That is, that the status and needs of Aboriginal students as learners of SAE may be ‘invisible’ in classroom interactions which make up a large part of these children’s educational experiences (Angelo & Hudson 2018; Dixon & Angelo 2014; McIntosh, O’Hanlon & Angelo 2012; Sellwood & Angelo 2013). These issues were explored through two research questions and five sub‐questions: 1) How are students choosing between variants in their linguistic repertoires as they talk during class time at school, a. Do students choose variants associated with SAE or the community variety according to interlocutor, topic of talk or the type of activity they are engaged in?; b. Are there changes in students’ rate of use of SAE and non‐SAE variants in their speech in the classroom over three years? 2) To what extent, and how, do teachers present SAE (as an additional language/dialect) as a learning focus for students in lessons, a. What are the norms and expectations for students’ ways of speaking in the classroom, as revealed through teachers, teacher aides and students’ practices?; b. Is SAE (AL/D) presented as a learning focus in literacy lessons, and how?; c. Is SAE (AL/D) presented as the main content to be learned in any lessons, and how? Data for the study was collected over three years, following two cohorts of students in the first four years of school, in an Aboriginal community in Queensland. Usual classroom lessons were audio and video recorded with the aim of capturing as closely as possible what would have been happening if researchers had not been present. Research Question 1 was investigated through two complementary approaches, providing qualitative and quantitative analysis. Variationist sociolinguistic methods were used to consider how linguistic and social factors influenced students’ choices between linguistic variants associated with the community variety and SAE, and the effect of change over time. Variation in absence and presence of the verb ‘be’ in the children’s classroom talk was taken as a case study for the focus of this analysis. Results showed that literacy task related topics of talk strongly favoured presence of the verb ‘be’. However, contrary to expectation, ‘be’ presence in the children’s classroom talk was not favoured with SAE‐speaking teacher addressees. The analysis did not show the expected increase in rate of ‘be’ presence with an increased length of time at school. Research Question 1 was additionally explored using a Conversation Analysis (CA) approach. CA analysis of classroom interactions showed ways in which students oriented to the social meanings of different ways of talking. In literacy tasks, children’s self‐talk showed how they navigated between variants in their linguistic repertoires, and children demonstrated in their interactions with peers and teachers that they associated certain words with particular ways of talking in the community. Research Question 2 was explored through analysis of classroom interactions from a CA perspective. Analysis revealed little explicit orientation from teachers to students being speakers of the community variety, or learners of SAE, with students being instead treated to a considerable extent as already speakers of SAE. Lessons ostensibly targeted at explicitly teaching linguistic forms were found to focus on topic‐specific applications of SAE words to academic tasks. The context where teachers attended most to non‐SAE aspects of students’ speech was in interactions centred on reading and writing tasks. However, in these interactions, there was evidence that students were treated primarily as learners of literacy, rather than learners of SAE. Both of the methodological approaches, CA and variationist sociolinguistics, drew on naturally occurring classroom data to provide insight into young Aboriginal students’ linguistic experiences encountering SAE as the medium of instruction at school. These analyses contribute new material to previous observations regarding the level of acknowledgement of Aboriginal SAE as an additional language or dialect learners at school (Dixon & Angelo 2014; McIntosh, O’Hanlon & Angelo 2012; Sellwood & Angelo 2013), providing insight into the visibility of these students’ existing linguistic knowledge and SAE learning needs in everyday classroom interactions central to their education.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School Educ & Professional St
Arts, Education and Law
Full Text

The research study described in this report was conducted in 2007 at a Kindergarten to Year 12 College, situated in the remote Kimberley region of Western Australia. Using case study methods, this research aimed to examine the scaffolding techniques used by two Reading Recovery teachers as they supported the language and literacy learning of two Indigenous Reading Recovery students. And further, to examine the impact of this scaffolding on each student’s language and literacy learning.
Multiple data sets were collected and examined with results discussed throughout this study. Transcripts and direct quotes were used to support the reporting of emergent themes and patterns with the convergence of the data used to support the internal validity of this small scale study.
This paper takes the position that generalisations, assumptions and stereotypical negative images of Indigenous students as disengaged and noncompliant students can be curtailed when teachers acknowledge that Indigenous students are active language learners with rich cultural and linguistic ‘funds of knowledge’ (Moll & Greenberg, 1990). These funds can support students’ new learning of literate discourse which is defined and used throughout this study as: the language used in schools to read, write and talk about texts used for educational purposes. Significantly, difficulties Indigenous students experience with literate discourse have been identified as contributing to the educational underachievement of this group of Australian students (Gray, 2007; Rose, Gray & Cowey, 1998, 1999).
The findings from this small scale study indicate that within the context of Reading Recovery teaching, teacher-student interaction and contingent teacher scaffolding, centred on text reading and writing experiences can support Indigenous students to code-switch between home languages and dialects, Standard Australian English and literate discourse.

Urban Aboriginal students often come to school with a different set of cultural and language learnings than those of their non- indigenous peers. These differences can pose major barriers for the primary- aged Aboriginal student trying to access the curriculum which is based on Standard Australian English (SAE). Aboriginal students often come to school speaking a recognised dialect of English, Aboriginal English (AE) which has its own grammatical, phonological, pragmatic and socio- cultural standards which at times are quite different from those of classroom language interactions. The mismatch between the language of the home (AE) and the language of the classroom (SAE) can have dramatic effects on the literacy learning of Aboriginal students and hence their ability to effectively read in Standard Australian English. This study aims to explore the question of whether changes would be evident in urban Aboriginal students (who speak Standard Australian English as a second dialect), following a targeted reading intervention program. This reading intervention program, called an "Integrated Approach" combined existing strategies in reading and second language I second dialect teaching and learning, with cultural understandings, in a methodology aimed at improving the reading ability of the participating Aboriginal students. The students who were the 5 case studies were part of a larger cohort of students within a wider study. Students were drawn from primary schools in urban localities within the Catholic Archdiocese of Brisbane in Queensland, Australia. Qualitative data collection procedures were used to observe the 5 case study students over a period of 6 months and quantitative measures were also utilised to support this data for the purposes of triangulation. Both data collection sources for the case studies and the wider study showed that the reading intervention program did have significant effect on reading accuracy, reading comprehension and the affective area of learning. The study revealed that by using the teaching I learning strategies described in the intervention program, combined with socio-cultural understandings which include respect for the students' home language and an understanding of the effects of learning English as a Second Dialect (SESD), educators can assist Aboriginal students m improving their abilities to read in SAE. Other positive effects on students' behaviours during the intervention program which were recorded during the study included: an improved attitude to reading; a new willingness and confidence in reading; an improved willingness to participate in language activities both in tutorial sessions and back in the classroom; improved use of decoding skills and an improved control over SAE grammatical structures in writing tasks. This study emphasises the need for educators to work ardently at increasing their own understanding of how best to assist Aboriginal students in becoming competent literacy learners in SAE. Closing the gap created by the mismatch between home and school language can only be achieved by educators exploring eclectic pedagogical options and valuing the Aboriginal student's home language as a vital learning tool in gaining this competence in SAE literacies. KEYWORDS Australian Aborigines; Aboriginal; urban Aborigines; Primary- aged students; Standard Australian English; English as a Second Language; Standard English as a Second Dialect; Aboriginal English; Standard Australian English; home language; socio- cultural; culture; language; oral language; oral culture; prior knowledge; literacy; reading; reading comprehension; reading strategies; modelling reading; literature; learning styles; mechanics of reading; code switching; standardised assessment.

Australian Aboriginal children experience disproportionate levels of health, educational and social disadvantage. Their significant disadvantage stands in stark contrast to the well-being of the majority of Australians. These poor outcomes are magnified in remote communities where Aboriginal children have been shown to have developmental vulnerability beyond the national average. A concerning and poorly understood determinant of development and well-being is the influence of prenatal alcohol exposure (PAE). National surveys show differences in the drinking patterns between Aboriginal and non-Aboriginal Australian women. Aboriginal women are less likely to drink than non-Aboriginal women but when they do consume alcohol, they do so at far more hazardous levels. As alcohol is a teratogen, PAE can have devastating effects on fetal and brain development leading to a spectrum of disorders termed Fetal Alcohol Spectrum Disorders (FASD). FASD are characterised by significant learning, behavioural, cognitive and motor deficits which disrupt education and development trajectories leading to severely limited occupational options and dependent living. These adverse life outcomes place enormous burden on families, their communities and social supports. The Fitzroy Valley in north Western Australia contains a unique, culturally rich population of 4,500 people (81% Australian Aboriginal), living in approximately 45 very remote communities with five distinct language groups. Over the last decade there has been growing anxiety amongst Aboriginal leaders in the Fitzroy Valley, that high-risk maternal drinking within many of their remote communities may be harming the development and future potential of children. This concern led to an invitation from Aboriginal leaders for researchers to collaborate with them on a project to evaluate the impact of in-utero alcohol exposure on child health and development. This project conducted in 2011 was named The Lililwan Project and is Australia’s first population-based study to determine FASD prevalence, using active case ascertainment, in remote Australian Aboriginal communities. Population-based data from this study indicate that high-risk alcohol use is common. Of the 127/134 (95%) eligible mothers and caregivers who participated in this study, it was reported that more than half (55%) of mothers drank. Of mothers who did drink, 52% did so at “risky” or “high risk” levels with 88% drinking in the first trimester and 53% drinking in all three trimesters. FASD diagnoses were determined in 21/108 (194.4 per 1000) children, one of the highest prevalence rates in the world. The FASD diagnostic process includes the assessment of neurodevelopmental functional outcomes in a number of central nervous system (CNS) domains known to be affected by PAE. Motor performance and its subset gross motor performance is one of several CNS domains recommended for assessment by four key international FASD guidelines. Despite this, data on motor function are rarely included in FASD prevalence or observational studies and therefore the association of motor performance and PAE or FASD is poorly understood. In the Fitzroy Valley, physical activity including football, basketball, netball, swimming and cultural activities such as hunting and traditional dance feature highly in recreational pursuits of children. Given concern that the motor skills needed to participate in these activities could be significantly affected by PAE, motor performance was included as a CNS domain for assessment in the Lililwan Project, with the results of this original research being reported in the following chapters. Chapter One provides an introduction to the context of this Thesis and a literature review of the existing evidence. The current Thesis contributes much needed evidence to support the neurodevelopmental needs of children with motor impairment associated with PAE or FASD who live in the Fitzroy Valley. This work is unique as cultural considerations and the very remote geographical location with extreme climate makes this population very difficult to assess. Not surprisingly, there is paucity of data related to motor performance of Aboriginal children living in very remote communities and currently no normative data or observational studies exist. The findings provide a significant evidence base to assist parents, clinicians, the education sector and policy makers, to make optimal decisions for management of children and their families living with FASD. The first aim of this Thesis was to characterize gross motor impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or “moderate” to “heavy” maternal alcohol intake. Chapter Two describes a systematic review where 2881 articles were identified of which 14 met the inclusion criteria. The subjects’ mean age ranged from 3 days to 13 years. Study limitations included failure to report cut-offs for impairment, non-standardised reporting of PAE, and small sample sizes. The meta-analysis pooled results (n=10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and gross motor impairment (Odds Ratio: 2.9; 95% Confidence Interval: 2.1–4.0). GM deficits were found in balance, coordination, and ball skills. There were insufficient data to determine the prevalence of gross motor dysfunction in the included cohorts. In conclusion, these results suggest that evaluation of gross motor proficiency should be a standard component of multidisciplinary FASD diagnostic services. The second aim of this Thesis was to identify a suitable standardised instrument to measure motor performance (including fine and gross motor skills) and determine its reliability for use in predominantly Australian Aboriginal children living in very remote communities and with risky levels of PAE. Chapter Three reports on this work. The Bruininks-Oseretsky Test of Motor Proficiency – Second Edition (BOT-2) Complete Form was identified after performing a literature review and consulting with national and international experts. Given the difficult logistical context in which the research was performed, it was decided to use the highly correlated short-form version of the BOT-2 for the reliability testing. A reliability study using the BOT-2 Short Form was then performed with a convenience sample (n=30) of children aged 7-9 years from the Lililwan Project (n=108). The inter-rater reliability for the BOT-2 Short Form score sheet outcomes ranged from 0.88 (95%CI, 0.77 – 0.94) to 0.92 (95%CI, 0.84 – 0.96) indicating excellent reliability. The test-retest reliability (median interval between tests being 45.5 days) for the BOT-2 Short Form score sheet outcomes ranged from 0.62 (95%CI, 0.34 – 0.80) to 0.73 (95%CI, 0.50 – 0.86) indicating fair to good reliability. The raw score Minimal Detectable Change was 6.12. In conclusion, the BOT-2 Short Form has acceptable reliability for use in remote Australian Aboriginal communities and will be useful in determining motor deficits in children prenatally exposed to alcohol. This is the first known study evaluating the reliability of the BOT-2 Short Form, either in the context of assessment for FASD or in Aboriginal children. The third aim of this Thesis was to describe motor performance in predominantly Australian Aboriginal children living in very remote communities (n=108) and to compare motor performance in children with no PAE, PAE or FASD. Chapter Four describes this work. Motor performance of the cohort was assessed using the modified BOT-2 Complete Form, and the relationship between motor skills, PAE, and FASD was explored. FASD diagnoses were assigned using the Canadian guidelines. Motor impairment sufficient to contribute to a CNS domain of impairment was defined according to these guidelines as a score two or more standard deviations (SD) below the mean. A total of 108 children (Aboriginal: 98.1%; male: 53%) with a mean age of 8.7 years were assessed. The cohort’s mean total motor composite score (mean±SD: 47.2±7.6) approached the Bruininks–Oseretsky Test of Motor Proficiency - Second Edition normative mean (50±10) despite high levels of risky PAE, social disadvantage, and poor fine motor skills. There was no difference between children with PAE and those without PAE (mean difference ± standard error: -2.2±1.5; 95% CI: -5.1 to 0.80). Motor performance was lower in children with FASD diagnosis than those children without a diagnosis (Mean Difference±SD: -5.0±1.8; 95% CI:-8.6 to -1.5). The prevalence of motor impairment (≥ 2SD below the mean) was 1.9% in the entire cohort, 9.5% in children with FASD, 3.3% in children with PAE and 0.0% both in children without PAE or FASD. In conclusion, these results show that almost 10% of children with FASD have significant motor impairment. Evaluation of motor function should routinely be included in assessments for FASD, to document impairment and enable targeted early intervention. The fourth aim of this Thesis was to characterise gross motor performance, as distinct from total motor performance as discussed above. In children participating in the Lililwan Project (n=108), a subset of the BOT-2 motor performance data that related to the gross motor performance of the cohort was extracted which enabled exploration of the relationship between gross motor skills, PAE, and FASD. Chapter Five describes this work. A total of 108 children (98.1% Aboriginal; 53% males, mean age: 8.7 years) were assessed. Half (52.2%) were exposed to at least “risky” levels of PAE and 21 (19%) were diagnosed with a FASD. The mean Gross Motor Composite score of the cohort (47.0±8.4) approached the BOT-2 normative mean (50.0±10) despite poor health and development indices, and was similar between children with and without PAE (MD±SD: -1.8±16.5; p=0.27). This mean score however, was significantly lower in children with FASD than those without (MD±SD: -5.5±20.6; p=0.006). Compared to children without FASD, children with FASD had (i) significant impairment in Subtests for Running Speed and Agility (MD±SD:-2.4±8.1; p=0.003) and Strength (MD±SD:-2.8±9.9; p=0.004) and (ii) a higher proportion than expected had overall gross motor impairment (≤2SD:9.5%; ≤1SD:23.8%). In groups with PAE, no PAE, and no FASD, gross motor function approached expected population norms and there were no significant difference in function between these groups. In conclusion, almost 10% of children with FASD had gross motor scores that indicated significant impairment whilst 25% of these children had scores which indicated a need for therapy. Evaluation of gross motor performance should routinely be included in FASD assessment to determine strategies to optimise child development. The fifth aim of this Thesis was to describe the presence of soft neurological signs (SNS) in predominantly Australian Aboriginal children (n=108) living in very remote communities where children had no PAE, PAE and FASD. Chapter Six reports on this work. The presence of SNS in the cohort was assessed using the Quick Neurological Screening Test – Second Edition (QNST -2) and the relationship between SNS, PAE, and FASD was explored. “Severe discrepancy” was defined as scores equal or below the 5th percentile while “moderate discrepancy” represented scores from the 6-24th percentile. FASD diagnoses were assigned using the Canadian guidelines. International expert opinion recommended that a QNST-2 Total Score of equal to or greater than 30 be used to define SNS sufficiently significant to contribute to a CNS domain of impairment. A total of 108 of 134 (80.6%) eligible children (mean age 8y 9mo, SD=6mo, 53% male) were assessed. The median QNST-2 Total Score for all participants was within the normal category (19.0, range 4–66) despite more than half (52.2%) of the cohort being exposed to at least risky levels of PAE. However, the median QNST-2 Total Score was higher in children with PAE than without PAE (r=0.2, p=0.045) and in children with FASD than without FASD (r=0.3, p=0.004). Half (8/16) of children scoring ‘moderate discrepancy’ and all (2/2) children scoring ‘severe discrepancy’ had at least three domains of CNS impairment. In conclusion, SNS were more common in children with PAE or FASD, consistent with the known neurotoxic effect of PAE. The QNST-2 is a useful screen for subtle neurological dysfunction and for indicating the need for more comprehensive assessment in children with PAE or FASD. The final aim of this Thesis was to systematically review the literature to investigate the efficacy of conservative interventions to improve gross motor performance in children with PAE or FASD or a range of similar neurodevelopment conditions. Chapter Seven describes this work. As no clinical trials for children with FASD were found, results from groups of children with similar neurodevelopmental disorders and mild to moderate gross motor impairment were considered. Of 2513 papers, 9 met inclusion criteria including children with cerebral palsy (CP) (n=2) or Developmental Co-ordination Disorder (DCD) 98 (n=7). There were 11 different interventions reported among the 9 included trials. Two of 9 trials showed an effect for treatment, and a meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (standardised MD:-0.8; 95%CI:-1.1 to -0.5) with “very low quality” Grading of Recommendations, Assessment, Development and Evaluations (GRADE) ratings. Using the most conservative trial outcomes there was no treatment effect (SMD:-0.1; 95%CI:-0.3 to 0.2) with “low quality” GRADE ratings. Study limitations included the small number and poor quality of the available trials. In conclusion, although we found that some interventions such as Taekwondo can improve gross motor outcomes in children with DCD or CP, our confidence is limited by the very low quality of the available evidence. High quality intervention trials are urgently needed. Chapter Eight provides a summary of the principal findings of this Thesis, describes implications of these findings, proposes directions for future research and presents recommendations. In conclusion, the series of studies reported in this Thesis provide the first data on motor performance, gross motor performance and SNS in a population-based cohort of predominantly Aboriginal Australian children with PAE. They represent the only data of this kind. The findings provide new information regarding the motor performance skills of Aboriginal children living in remote communities, and demonstrate the significant impairments that children with a FASD suffer. This work has significant implications for future studies of FASD prevalence emphasising the importance of assessing motor performance as a component of CNS function. The findings also highlight the impact of alcohol on child development particularly motor performance and indicate the critical need for allied health services to ensure the health and well-being of these most vulnerable children.

Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007.
Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.

In this research, I explore my belief that one the reasons for the continuing poor outcomes for Indigenous people was that State-wide and national programs ignored unique local Indigenous culture and did not actively involve local Indigenous people in the development of programs for their area. I chose to examine this perception through investigation of the tension between Indigenous culture and worldview and the dominant White values of the child welfare system (broadly defined), through description of Martu child rearing practices and beliefs in the remote Western Australian town of Wiluna. The Martu live in a remote environment of material poverty, high levels of unemployment, low levels of educational achievement and poor health outcomes. The research sponsored by the Ngangganawili Aboriginal Health Service and located in its Early Childhood Centre, uses an Indigenous research approach based on Brayboy's (2005) TribalCrit to explore Martu child rearing practices, beliefs and values. It uses the stories told by the Martu in Wiluna about the way they and their families were brought up and observations of Martu families to answer research questions around Martu definitions of children and families, their concerns for their children, ways of ensuring the well being of their children, and whether there is a Martu child welfare approach. The research then considers the implications of these Martu practices for the broadly defined child welfare system. The stories told by the Martu show that they have a unique way of bringing up their children that is different to those in the dominant White culture. This uniqueness is derived from a combination of the recent colonisation of the Martu, their culture and their post colonisation experiences. The implications of Martu child rearing for the child welfare system are based on the assumption that Martu are wholly dependent on poorly designed and targeted government provided or funded services, and the current ways of delivering these services is failing the Martu. The research concludes that the key to improving outcomes for Martu children and their families is for the agencies delivering these services to form close working relationships with the Martu; operate within, understand, appreciate, and respect Martu Law and culture; understand their (personal and agency) and Martu post colonisation histories; and allow for Martu control, definition of priorities and development of strategies to address the problems.

In August 2000, Justice O�Loughlin of the Federal Court of Australia handed down the decision in Cubillo v Commonwealth in which Lorna Cubillo and Peter Gunner took action against the Commonwealth Government, arguing that it was vicariously liable for their removal from their families and communities as children and subsequent detentions in the Northern Territory during the 1940s and 1950s. The case is the landmark decision in relation to legal action taken by members of the Stolen Generations. Using the decision in Cubillo as a key site of contestation, my thesis provides a critique of legal positivism as the dominant jurisprudential discourse operating within the Anglo-Australian legal system. I argue that the function of legal positivism as the principal paradigm and source of authority for the decision serves to ensure that the debate concerning reconciliation in Australia operates rhetorically to maintain whiteness at the centre of political and discursive power. Specifically concerned with the performative function of legal discourse, the thesis is an interrogation of the interface of law and language, of rhetoric, and the semiotics of legal discourse. The dominant theory of evidence law is a rationalist and empiricist epistemology in which oral testimony and documentary evidence are regarded as mediating the relationship between proof and truth. I argue that by attributing primacy to principles of rationality, objectivity and narrative coherence, and by privileging that which is visually represented, the decision serves an ideological purpose which diminishes the significance of race in the construction of knowledge. Legal positivism identifies the knowing subject and the object of knowledge as discrete entities. However, I argue that in Cubillo, Justice O�Loughlin inscribes himself into the text of the judgment and in doing so, reveals the way in which textual and corporeal specificities undermine the pretence of objective judgment and therefore the source of judicial authority.

The purpose of this study was to describe the sense of self for a group of urban Western Australian Aboriginal children through analysing their perspectives and experiences in school sport and physical education. A symbolic interaction inquiry paradigm complemented with qualitative data collection methods was utilised. Informal conversational interviews and nonparticipant observations were employed. Interviews were conducted with participants and those whom they reported as their significant others. Participants were also observed in the school sport setting during physical education classes and intra and inter school sport competitions. Eight Western Australian Aboriginal children who resided in an urban suburb of Perth, Western Australia and attended a coeducational state school were the participants. Upper primary students, aged 11 to 12 years were included with an equal representation of both males and females. Data were analysed in accordance with Colaizzi’s (1978) procedure. Significant participant responses were extracted and meanings were identified in order to group the meanings into various themes. It was found that Aboriginal students mostly experienced positive interactions with others in the school sport setting. They demonstrated above average sport skills and were consistently rewarded with praise from their fellow peers and teachers. Aboriginal students did not enjoy physical education since it limited their participation, social interaction with others and their enjoyment. Team sports were preferred, but females reported that they disliked coeducational sport competition. Aboriginal students reported that participating in sport (particularly team sports) made them feel happy about themselves since it provided an opportunity for them to feel proud of identifying as an Aboriginal. Opportunities for equality and acceptance from others were more accessible in the school sport domain, since feedback for performances was constant and contained positive information. Feedback was often supplied immediately after a performance and was directed to the student concerned. For some though, sport participation could also result in students experiencing shame. This occurred when a mistake was performed or when significant "others" were present and observed their participation. In all, school sport provided the opportunities for Aboriginal students to develop positive and favourable self-perceptions, particularly with regard to their Aboriginal identity.

This thesis is a seminal in-depth study of how non-indigenous writers and illustrators construct Aboriginal childhood in children's fiction from 1841-1998 and focuses not only on what these say about Aboriginal childhood but also what they neglect to say, what they gloss over and what they elide. This study probes not only the construction of aboriginal childhood in children's fiction, but explores the slippage between the lived and imagined experiences which inform the textual and illustrative images of non-Aboriginal writers. This study further contends that neo-colonial variations on the themes informing these images remain part of Australian children's fiction. Aboriginal childhood has played a limited but telling role in Australian children's literature. The very lack of attention to Aboriginal children in Australian children's fiction - white silence - is resonant with denial and self-justification. Although it concentrates on constructions of aboriginal childhood in white Australian children's fiction, this study highlights the role that racial imagery can play in any society, past or present by securing the unwitting allegiance of the young to values and institutions threatened by the forces of change. By examining the image of the Other through four broad thematic bands or myths - the Aboriginal child as the primitive; the identification of the marginalised and as the assimilated and noting the essential similarities that circulate among the chosen texts, this study attempts to reveal how pervasive and controlling the logic of racial and national superiority continues to be. By exploring the dissemination of images of Aboriginal childhood in this way, this study argues that long-lived distortions and misconceptions will become clearer
Doctor of Philosophy (Literature)

Nontypeable Haemophilus influenzae (NTHi), Streptococcus pneumoniae and Moraxella catarrhalis are common bacterial agents of otitis media which is a major cause of morbidity in young children. Mucosal immune responses are an integral part of the immune defense against middle ear infection and it is known that certain populations, including Australian Aboriginal children, are highly susceptible to disease. The current study focussed on the development of the mucosal immunity to the three bacterial pathogens in Aboriginal and non-Aboriginal children from birth to two years of age, living in the Kalgoorlie-Boulder region of Western Australia. Salivary and breast milk IgA levels were measured by the enzyme Linked immunosorbent assay. The measured IgA levels, combined with socio-economic, demographic and bacteriological data were analyzed statistically to determine the influential factors on the mucosal IgA response in these children over time. This study found that each antigen-specific IgA examined followed a distinct ontogeny pattern and IgA responses differed significantly according to age, indigenous status and feeding type. Indoors smoke exposure, maternal smoking, and sibling day care attendance had some impact on salivary IgA levels in the children. However, household crowding and the presence of older siblings had the most significant impact on salivary IgA levels for children of different age groups. These two factors were correlated to increased nasophayrngeal colonization by H. influenzae, S. pneumoniae and M. catarrhalis and colonization status was also found to influence salivary IgA levels in the children. No correlation between maternal breast milk IgA levels and child salivary IgA levels was observed. The results suggest that the degree of exposure to environmental factors rather than immunological deficit is responsible for the observed differences in salivary IgA responses between Aboriginal and non-Aboriginal children and modifying these factors could lead to a reduction in the burden of otitis media experienced by the children. Further studies correlating specific salivary IgA levels to diseases such as otitis media will reveal the role of specific salivary IgA responses in the prevention of infection by respiratory pathogens.

Introduction Addressing the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous Australians is a national health priority. The life expectancy of Aboriginal and Torres Strait Islander Australians is currently 70 years for males and 74 years for females, which is 10 years lower than that of non-Aboriginal Australians. Around 80% of the mortality gap is attributable to chronic disease across all ages, with cardiovascular diseases specifically accounting for around 24% of the mortality gap. Aboriginal and Torres Strait Islander Australians have a higher prevalence of cardiovascular disease (27% vs 21%), diabetes (18% vs 5%) and chronic kidney disease (22% vs 10%), with Aboriginal and Torres Strait Islander showing higher prevalence of these conditions during early adult life. Rates of end stage kidney disease are five-fold higher among Aboriginal and Torres Strait Islander Australians compared to non-Indigenous Australians. Cardiovascular disease, diabetes and chronic kidney disease have a number of shared risk factors such as obesity, smoking, hypertension, diet and physical activity as well as perinatal risk factors such as low birth weight. Almost all studies investing the prevalence of risk factors for chronic disease have been cross sectional, with very few having tracked the risk of developing chronic kidney disease through childhood and adolescence into adult life. The Antecedents of Renal Disease in Aboriginal Children (ARDAC) is a population based long-term cohort study, the details of which have been published previously. Commenced in 2002, at an average age of 8.9 years, the original cohort of ARDAC participants has been followed up through mid-childhood, and at four years of follow up (at an average age of 13.3 years) no differences in the prevalence of albuminuria, high systolic blood pressure or obesity between Aboriginal and non-Aboriginal children were observed. The overarching hypothesis of my doctoral research is the higher prevalence of chronic disease in Aboriginal people becomes evident in adolescence and early adult life, and that this inequity is largely explained by the social determinants of health. The aims of my doctoral research was to extend the follow up of the ARDAC Study to 10 years (mean age 16 years), and compare the prevalence of albuminuria and change in blood pressure and body mass index (BMI) from childhood to adolescence using a longitudinal approach to data analysis. I also investigated the influence of the risk factors of residential remoteness, socioeconomic status and birth weight on these early indicators of adult chronic disease. I also aimed to further investigate the influence of the social determinants of health on the incidence of chronic kidney disease through a systematic review of the literature and meta-regression analysis. Finally I aimed to investigate the prevalence of obesity and hypertension in young people in the general Australian population though use of the microdata available from the Australian Health Survey, and to identify behaviour risk factors for hypertension and obesity. Beginning the trajectory to ESKD in adult life: Albuminuria in Australian Aboriginal children and adolescents Globally, disadvantaged populations suffer a high burden of chronic kidney disease. The trajectory to chronic kidney disease during childhood and adolescence remains unclear due to a paucity of longitudinal studies. 3418 participants (1469 non-Aboriginal and 1949 Aboriginal) were enrolled in a prospective, population based cohort study at participating schools across New South Wales (NSW), Australia since 2002. Albumin: creatinine ratio was measured by dipstick every two years along with body mass index (BMI), blood pressure. We used multivariable logistic generalised estimating equation models to examine if Aboriginal children had a higher prevalence of albuminuria compared with non-Aboriginal children with increasing age, and to identify potential risk factors. At enrolment with a mean age of 10.6 years, 14.2% of children were obese and 16.0% overweight, and 11.5% were found to have albuminuria. Over 8 years (11,387 participant-years) of follow up the prevalence of albuminuria increased to 18.5%, overweight to 16.1% and obesity to 17.2%. BMI standard deviation score (SDS) was found to have a differential effect on the risk of albuminuria in Aboriginal and non-Aboriginal children (P interaction < 0.01). The prevalence of albuminuria decreased as BMI SDS increased in both groups of children, but more in non-Aboriginal children, leading to a 2.5% higher prevalence of albuminuria in overweight Aboriginal children (95 CI%: 1.0 to 4.2%). Compared with non-Aboriginal children, Aboriginal children are of higher risk of albuminuria when overweight or obese. These findings suggest that interventions to reduce the prevalence of overweight and obesity, particularly in adolescence and early adult life, are of critical importance to reduce the higher burden of chronic kidney disease experienced by Aboriginal Australians. The differential effect of socioeconomic status, birth weight and gender on body mass index in Australian Aboriginal Children Adult Aboriginal Australians have 1.5 fold higher risk of obesity but the trajectory of body mass index (BMI) through childhood and adolescence and the contribution of socioeconomic factors remain unclear. Our objective was to determine the changes in BMI in Australian Aboriginal children relative to non-Aboriginal children as they move through adolescence into young adulthood, and to identify risk factors for higher BMI. A prospective cohort study of Aboriginal and non-Aboriginal school children commenced in 2002 across 15 different screening areas across urban, regional and remote New South Wales, Australia. Socio-economic status was recorded at study enrolment and participants’ BMI was measured every 2 years. We fitted a series of mixed linear regression models adjusting for age, birth weight and socioeconomic status for boys and girls. 3418 (1949 Aboriginal) participants were screened over a total of 11,387 participant years of follow up. The prevalence of obesity was 14.2% (mean age 11 years) at baseline, and increased to 17.2% by a mean age of 16 years. The mean BMI increased with age and was significantly higher among Aboriginal girls compared to non-Aboriginal girls (P<0.01). Girls born at low birth weight had a lower BMI than girls born of normal birth weight (P<0.001). Socioeconomic status and low birth weight had a differential effect on BMI for Aboriginal boys compared to non-Aboriginal boys (P for interaction = 0.01). Aboriginal boys of highest socioeconomic status, unlike those of lower socioeconomic status, had a higher BMI compared to non-Aboriginal boys. Non-Aboriginal boys of low birth weight were heavier than Aboriginal boys. Socioeconomic status and birth weight have differential effects on BMI among Aboriginal boys, and Aboriginal girls had a higher mean BMI than non-Aboriginal girls through childhood and adolescence. Intervention programs need to recognise the differential risk for obesity for Aboriginal and non-Aboriginal boys and girls to maximise their impact. Blood pressure in Aboriginal and non-Aboriginal children through childhood and adolescence Hypertension is associated with an increased risk of chronic kidney disease (CKD) in adulthood. Aboriginal adults have a higher prevalence of hypertension, but whether this develops during childhood and adolescence is unclear. Our aim was to determine relative changes in blood pressure between Aboriginal and non-Aboriginal children as they move through adolescence into young adulthood. A prospective cohort study of Aboriginal and non-Aboriginal schoolchildren commenced in 2002 across NSW. Blood pressure was measured every 2 years. We fitted a series of mixed linear regression models for systolic and diastolic blood pressure adjusting for age, sex, Aboriginality, birth weight and socioeconomic status (SES). 3418 (1949 Aboriginal) participants were screened over a total of 11, 387 participant years follow up. At study enrolment at a mean age of 11 years, , the prevalence of high systolic blood pressure (SBP SDS > 95th centile) was 7.2% which increased to 15.4% at eight years follow up (mean age was 15.36 years). Although age and birth weight had a differential effect on systolic blood pressure for Aboriginal boys, the difference in systolic blood pressure was minor. The was no difference in the systolic blood pressure of Aboriginal girls compared to non-Aboriginal girls. For both boys and girls, lower socioeconomic status was associated with an increase in systolic blood pressure of approximately 2.5 mmHg. The prevalence of high diastolic blood pressure was approximately 3% for both boys and girls and remained constant over follow up. Socioeconomic status had a differential effect on blood pressure for Aboriginal children, with lower socioeconomic status associated with lower diastolic blood pressure for both boys and girls. The prevalence of high systolic blood pressure increased through adolescence, with no difference in systolic blood pressure for Aboriginal participants compared to non-Aboriginal participants. Low socioeconomic status is associated with an increase in systolic blood pressure among children and adolescents, and targeted intervention for young people of low socioeconomic status is required to control blood pressure within our community. The social determinants of chronic kidney disease: a systematic review Socio-economic disadvantage is increasingly recognised as an important risk factor for chronic disease, but the strength of the association with the development of chronic kidney disease (CKD) and the contribution of the various domains of disadvantage are uncertain. The aim of this study was to synthesise the evidence regarding the risk of CKD and end stage kidney disease (ESKD) in the general population according to markers of socio-economic disadvantage. We performed a systematic review and meta-analysis of published primary articles in MEDLINE, EMBASE or CINAHL (until December 2014), risk of bias was assessed using the Newcastle Ottawa Scale and summary effects were estimated using random effects meta-analysis and meta-regression. Cohort studies conducted in the general population and the social determinants of health investigated were ethnicity, education, income, occupation and area level measures of socio-economic status with the outcome of interest incident CKD (any stage). We identified 21 studies (n=12,987,147) - 13 investigated risk by ethnicity, education (9), income (6), area level socio-economic status (4) and occupation (2). Only two of the included studies were of high risk of bias. Black Americans have more than double the risk of ESKD compared to white Americans (hazard ratio 2.33, 95% confidence interval 2.02 to 2.63, I2 59%). Low income was found to increase risk of ESKD in four of the six studies identified, however low education and low SES were not consistently identified as risk factors for CKD. Measurement of domains, and thresholds used to define disadvantage were heterogeneous so that summary estimates were generally not able to be calculated. Although there is a substantial body of evidence regarding the association between socioeconomic disadvantage and CKD, there appears to be an inconsistent relationship. This may be artefactual, due to difficulties in quantifying disadvantage, or reflect true underlying differences in the association across different settings. Obesity and hypertension in Australian young people: Results from the Australian Health Survey 2011 to 2012 Few studies have focused on the prevalence of hypertension and obesity among young people (ages 15 to 25), although there is increasing awareness that preventative programs need to target this age group. We examined the prevalence of overweight, obesity and hypertension among 2 163 young people in Australia using data from the Australian Health Survey 2011 to 2012 and aimed to identify behavioural risk factors using logistic regression. The prevalence of obesity increased from 7.5% to 15% through the ages of 15 to 25 among boys, whilst the prevalence of overweight and obesity remains constant among girls throughout this age group (14%). Low levels of physical activity was shown to be a strong risk factor for obesity for both boys (odds ratio 5.95, 95% CI 1.83 to 19.36) and girls (OR 3.20 95% CI 0.69 to 14.87). Low socioeconomic status was associated with obesity among girls only. Although the prevalence of hypertension is low in this age group, the prevalence of high normal blood pressure is high especially among men (28% men and 14% women). Our results suggest that programs targeting physical activity participation should be tailored differently for boys and girls, with a focus on girls during late childhood and early adolescence but late adolescence and early adult life for boys.

This thesis is a history of schooling for Indigenous children in Western Australia between the commencement of the first Aboriginal school in Perth in 1840 and 1978. The thesis represents the view that, for most of this period, and regardless of policy, education for Indigenous children was directed towards changing their beliefs and behaviours from being distinctly Aboriginal to recognizably European. Four major policies for Aborigines provide the framework for the thesis, these being amalgamation (1840-1852), protection (1886-1951), assimilation (1951-1972) and self-determination (1973-). The amalgamation of the Indigenous population with the small colonial society in Western Australia was a short-lived policy adopted by the British Colonial Office. Protection, a policy formalised by Western Australian legislation in 1886, 1905 and 1936, dominated Aboriginal affairs for the first half of the 20th century. Under this policy the Indigenous population was regarded as two distinct groups - a diminishing traditional population to be segregated and protected and an increasing part-Aboriginal population that was to be trained and made ‘useful’. In 1951 Western Australia accepted a policy of assimilation, coordinated by the Commonwealth government, which anticipated that all people of Aboriginal descent would eventually be assimilated into the mainstream Australian society. This policy was replaced in 1973 by one of Aboriginal community self-determination, an initiative of the Commonwealth government and adopted throughout Australia. The attempts at directed cultural change were evident in the ‘Native’ schools that opened in Perth, Fremantle and Guildford in the 1840s where it was assumed that the separation of children from their families and a Christian education would achieve the transition from a ‘savage to civilized’ state. For another century the education of Indigenous children on missions and in government settlements was founded upon similar assumptions. The thesis acknowledges that the principal change agents, such as the Chief Protectors of Aborigines, mission administrators and the teachers in direct contact with the children, seriously underestimated both the enduring nature of Indigenous culture and the prejudice in Australian society. Between 1912 and 1941 a few government schools in the southern districts of Western Australia refused to admit Aboriginal children. The exclusion of these children is examined against a background of impoverished living conditions, restrictive legislation and mounting public pressure on the State and Commonwealth governments for a change in policy. The change did not begin to occur until 1951 when the Commonwealth and States agreed to a policy of assimilation. In Western Australia this policy extended education to all Aboriginal children. The thesis explores the provision of government teachers to Aboriginal schools in remote areas of Western Australia between 1951 and 1978. The final chapter examines Indigenous perceptions of independent community schools within the first five years of the policy of self-determination and contrasts the objectives and management of two schools, Strelley in the Pilbara and Oombulgurri in the Kimberley.

In Australia, over-representation of Aboriginal and Torres Strait Islander children in child protection systems is increasing. The legacy of the stolen generation has led to grief, sadness and loss of identity for many people, and major disparities in health, education, employment and housing means that Aboriginal and Torres Strait Islander families are more susceptible to child welfare interventions in the present and future. This makes it imperative that responses for these families are more effective, in order to achieve socially just outcomes. As well, Australia’s growing multicultural society has increased demand for services provided to people from diverse cultural backgrounds to recognise the impact and importance of culture and to respond effectively. Cultural competency, which focuses on developing knowledge, skills and values for cross cultural practice, has gained momentum. It aims to enhance the ability of workers to provide culturally relevant and effective responses to people from different cultural backgrounds. However, ensuring that practices in the human services are culturally appropriate, culturally safe, salient, and effective, has proved elusive.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Human Services and Social Work
Griffith Health
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Knowledge of Indigenous language and identity for Australian Indigenous children is vital. Despite this there has been little research into the effects that living culture practice affords Australian Indigenous children through learning heritage language. Yarrabil (to sing) is one way in which Indigenous youth can participate in learning Indigenous language. Through a series of surveys, wula bora (focus group) sessions, interviews and reflections, the jarjum (children) of the Yugambeh language region assisted to discover how the process of participation in an urban Aboriginal children’s language choir can play an integral part in youth leadership, language acquisition, well-being (self-efficacy), and Identity and Aboriginality. The research also demonstrates how a language choir can safe-guard language and culture whilst building socio-cultural capital within an Indigenous community. The National Indigenous Languages Survey Report of 2005 listed the Aboriginal language Yugambeh of the Gold Coast, Logan and Scenic Rim regions of South-East Queensland, Australia as endangered. This thesis investigates an alternate way to girrebba (wake up) a sleeping language and engage youth in the process of learning their heritage language. The ‘Yugambeh Language and Song project’ provides academic knowledge in a relatively unstudied field, supports living culture practice and provides a model to assist other Indigenous communities to sing their language alive.
Thesis (Masters)
Master of Arts Research (MARes)
School of Humanities, Languages and Social Science
Arts, Education and Law
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Background: Australian public policy prioritises the development of evidence-based and culturally appropriate oral health promotion to improve the oral health of Aboriginal people, including children. Aim: This thesis aims to identify themes of effective and culturally appropriate oral health promotion targeting Indigenous children in high-income nations; develop, implement and evaluate oral health promotion for Aboriginal children in rural and remote communities in NSW and determine if these strategies are effective and sustainable. Methods: A collaboration took place with three Aboriginal communities in Central Northern NSW, Australia, in 2014 to collect baseline oral health status of Aboriginal children and inform potential oral health promotion strategies. In 2015, a suite of oral health promotion strategies were co-designed with Aboriginal communities in Central Northern NSW including in-school toothbrushing, installation of refrigerated and filtered water fountains, water bottle program, distribution of fluoride toothpaste and toothbrushes; dental health education and a structured fluoride varnish program. These strategies were implemented in three schools in the region in 2016. The fluoride varnish program was also implemented in seven schools in NSW in 2017 piloting Aboriginal dental assistants to apply fluoride varnish. Oral health promotion was evaluated to determine feasibility, sustainability and impact. Results: Community-led oral health promotion strategies significantly reduced dental caries among children, increased positive oral hygiene behaviours and were considered sustainable. School fluoride varnish programs are feasible and Aboriginal dental assistants can safely provide children with at least three fluoride varnish applications per year using this approach. Discussion and Conclusion: Co-designed and community-led oral health promotion is effective and sustainable and may be a solution to improving the oral health of Aboriginal children.

This thesis is the first to demonstrate the most appropriate spirometry and FeNO reference values for use amongst Aboriginal and Torres Strait Islander children and young adults. Availability of this data will lead to improved accuracy of spirometry and FeNO interpretation which will aid in more timely diagnosis and management of respiratory conditions for this population. Results from this study also suggest that healthy Australian Indigenous lung function data may not be as low as previously reported in earlier studies.

Thesis (Ph. D.)--University of Sydney, 2006.
Title from title screen (viewed 28 March 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Linguistics, Faculty of Arts. Includes bibliographical references. Also available in print form.

The reading and school performance of Aboriginal and Torres Strait Islander (A & TSI) children has been reported to be poorer than that of the wider community. The known association between reading and vision formed the basis of the principal hypothesis tested in this thesis that the poor reading performance of these children has a visual basis. Two experiments made up the main study which examined the visual characteristics and reading performance of children attending two different urban schools; the Holy Rosary school, which catered for children from many ("mixed") cultural backgrounds and the St Francis school, whose students were predominantly of A & TSI culture. In experiment I, the visual characteristics of 41 A & TSI children (13 from the Holy Rosary school, 28 from the St Francis school), aged between 8 and 11 years were measured. In general, A & TSI children exhibited low hyperopic refractive errors and other optometric findings were similarly within normal limits. Agematched data for 13 A & TSI children from each of the two schools was also compared. Horizontal eye movement ability and reading comprehension skills were significantly poorer in the A & TSI children attending the "mixed" (Holy Rosary) school, while the perceptual skills of the A & TSI students attending the "A & TSI" (St Francis) school were significantly worse. The second experiment investigated the vision and reading performance of A & TSI and non-A & TSI children attending the same school. Age-matched data of 13 A & TSI and 13 non-A & TSI students were analysed. While the visual profiles of the A & TSI and non-A & TSI students were not significantly different, the reading accuracy and comprehension scores were significantly worse in the A & TSI children when compared with the non-A & TSI group. The results from both experiments are consistent with previous reports of poor reading performance in A & TSI children but argue against poor vision being the cause of this reduced reading performance. As an adjunct to this study, the Turtle chart, designed specifically for use with A & TSI children, was evaluated. The vision of 97 students, 60 A & TSI and 37 non-A & TSI students, aged between 6 and 12 years, was measured using both a standard Bailey-Lovie chart and a Turtle chart. The results obtained with the two charts were highly correlated, indicating that the Turtle chart is a culturally appropriate alternative for the measurement of vision in A & TSI children.

The present thesis explores the effects of racism on Aboriginal children’s social and emotional wellbeing (SEWB) and Aboriginal pregnant women’s mental health and wellbeing. Identification of protective factors against the effects of racism on child wellbeing was also contemplated. The thesis comprises seven chapters. Chapter 1 includes a review of the literature on characteristics of the Aboriginal Australian population and the effects of racism across the lifespan. This chapter also contemplates the Aboriginal Australian perspective on health and wellbeing and the role of ethnic-racial identity on Aboriginal Australian’s positive development. Chapter 2 describes the thesis’s aims and expected contributions. It describes the data sources in which the findings are based and the research questions explored. Chapters 3-6 include four peer-reviewed and published studies. The first study (chapter 3) is based on data from 369 Aboriginal pregnant women participating in the South Australian Aboriginal Birth Cohort Study. The findings show that racism is a pervasive experience, manifesting in the different settings (e.g., educational settings; public transport) in which Aboriginal pregnant women perform their daily activities. Racism was shown to be associated with increased stress and lower sense of personal control in this population. The next studies (chapters 4-6) were based on data from the Longitudinal Study of Indigenous Children (LSIC). Sample sizes varied according to the waves of the study included in the analyses. The second study (chapter 4) shows the effects of racism on Aboriginal children’s different social and emotional wellbeing (SEWB) domains. Risk ratios were calculated to estimate the effects on children’s emotional difficulties, peer problems, hyperactivity, conduct problems, and overall emotional and behavioural difficulties. The effect-measures indicated that the effects of racism on SEWB can be observed 1-2 years after exposure. In the third study (chapter 5), evidence was found for construct validity, reliability, criterion-validity, and measurement invariance by gender for a brief measure of Aboriginal children’s ethnic-racial identity (ERI) affirmation. These results provided evidence indicating the measure of ERI is valid, and it was then used in the subsequent study. The fourth study (chapter 6) showed that the effects of racism on SEWB was attenuated among Aboriginal children who had pronounced ERI affirmation. Implications for the protective role of ERI to different domains of SEWB were discussed. Finally, chapter 7 offers a summary of the overall findings and implication for this area of research. A list of references is provided within each chapter. The findings presented provide evidence of the impact of racism on Aboriginal pregnant women and Aboriginal children’s SEWB. Results from two modern cohorts indicated that Aboriginal pregnant women and Aboriginal children are subjected to racism in everyday settings, with associations between racism and poor SEWB and mental health. Evidence of validity and reliability was found for a measure of ERI affirmation in Aboriginal children. Furthermore, it was found that ERI affirmation might protect Aboriginal children against the impact of racism on SEWB. The findings show the effects of racism from a longitudinal perspective. The use of LSIC data is another strength, as LSIC is potentially the largest cohort study on determinants of Aboriginal children’s development and wellbeing. Future research can monitor the intergenerational effects of racism among Aboriginal Australians and the protective role of ERI affirmation across development.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Dental School, 2020

Research Doctorate - Doctor of Philosophy (PhD)
This thesis is the examination of stories of women taken from their families of origin as part of an assimilation process carried out in Australia. What is unique about the women’s stories in this thesis is the identification of a process of disturbance deliberately enacted upon them with the goal of shifting their identity away from what it would have been if they had been able to stay within their family of origin. It is the main premise in this thesis that there was a deliberate process of disturbing the body, minds or psyche as well as the lived culture of these women. Hence, through body, mind as well as cultural dysphoria, Stolen Generations are challenged to construct an identity.

The 1938-1940 Report of the Aborigines Protection Board, and the hearings and minutes of evidence that led up to it, discussed a dual track policy for the state approach to Aboriginal people.1 First, to “preserve” “full blood” Aboriginal people by relocating and isolating the residents of a number of reserves onto a single “giant reserve,” under the supervision of one white man. Second, was “assimilation of the [non-reserve] aborigines into the general community.”2 The giant reserve was never created, but there were mergers between reserves which entailed the forcible relocation of entire Aboriginal communities from one location to another. Commenting on these relocations in 2005, co-founder of Walgett Aboriginal Medical Service and one-time resident of Angledool Reserve, George Rose, wrote: The moving of Angledool – it was deeper than what people thought. It was the first step to destroying our Aboriginal culture… even I could see that, as a 13 year old. I could see that by combining the three tribes they were destroying the cultures.3 So, thirteen-year-old George Rose recognized that the mergers were an existential threat to Aboriginal cultures: that “preservation” brought destruction. And the Aborigines Protection Board recognized that there was something to preserve in Aboriginal culture, but failed to understand what and how. What did George Rose recognize? What is a culture? What was wrong with the colonial “preservation” policy and why did it destroy that which it nominally sought to protect? What, in short, sustains colonialism? There is a significant body of excellent anthropological, sociological, and historical scholarship on this topic, but less in the way of philosophical discourse. From a philosophical perspective, we can begin to identify and unpack what is at the core of these questions. From a philosophical perspective, they become questions of the what it means to be human in relation to other humans, and to be humans-in-relation in a colonial context. We can ask what it means to be differently, and what the possibilities of relation with others are. George Rose was a Yawaalaraay man, born on a reserve. He and his mother, Linda Fernando, were both forcibly removed from their families during their youth and sent to boarding houses.4 They, among many others, were subjected to a colonial attempt at erasing their identity, their difference from the colonial concept of being a modern human. George Rose’s life of activism can be read as a response to this colonial imposition, an attempt to make others recognize what he recognized at thirteen. Using a philosophical lens, we can ask the question at the heart of this thesis: what is the relation between recognition and colonialism?

Annual reports of Indigenous disadvantage mark the inability of children in very remote Aboriginal communities of the Northern Territory (NT) to meet national benchmarks in education. On their entry into the school system, these children are usually identified by the Diagnostic Net T-2 Continua as being behind their mainstream counterparts. After more than a decade of living and teaching in a very remote Aboriginal community for the NT Department of Education (DoE), it is apparent to me that there is a disconnect between the actual and expected development of Standard Australian English (SAE) speech of very remote Aboriginal school students. There is scant research on the language development of very remote Aboriginal children and to date, there are no studies that have investigated their development of English as a Second Language (ESL) within the very remote context. Those involved in education acknowledge the key constructivist or social-cultural premise that it is language that mediates relationships and understanding, yet the current accounts that describe how these children learn to speak and understand English are incomplete. The relationship between speech and literacy is well established and ESL research has highlighted that first language factors influence the developmental acquisition sequences for ESL. The research questions for this study aim to identify the characteristics of the developing SAE ESL speech for a group of very remote Aboriginal school children from four Central Western Desert communities. For linguists, two interrelated and accepted measures of early language competency and development are the Mean Length of Utterance (MLU) and the grammatical morpheme stages of learning. This study examined both aspects of the developing SAE ESL speech of 30 children over an eight-month period in the 2008 Indigenous Language Speaking Student (ILSS) program. The ILSS children selected were a linguistically homogenous Aboriginal language group of school-aged children from four very remote Aboriginal Communities in the Central Western Desert of the NT. This study reinforces earlier findings that an ESL learner’s first language influences the developmental and acquisition patterns for ESL and this study is the first to consider the influence of an Aboriginal language on developing SAE in this way. The results of this study are divided into two sets. The group results [collective] are within Set A and there are two case studies [individual children] in Set B. The aim was to investigate SAE ESL speech development to determine the existence of and describe any general patterns of speech development. The data was collected using culturally appropriate techniques developed by the NT DoE, in negotiation with community stakeholders. Analysis of the data from this study reveals the differences between the actual and expected SAE ESL rates of progression by identifying and charting the oral language capabilities of these children. Findings indicate that the ILLS children are in the initial stages of SAE ESL development, which is clearly reflected in the length of their utterances and also in their varied use of grammatical morphemes. These initial stages of SAE ESL development are characterised by speech that is telegraphic in style and format, typically with a range of inconsistently applied grammatical morphemes. Overall, the grammatical morpheme results revealed that these children are within the beginning developmental phases and they display the inchoate characteristics of such learners. The results showed that the children exhibit a range of grammatical morphemes across MLU stages and this diversity warranted closer inspection. This revealed that at this early stage of language development, rather than a linear acquisition profile for grammatical morphemes, it is prudent to examine the frequency ratios and create a priority list that will enable very remote teachers to better orchestrate ESL oracy in their classrooms. Consequently, drawing on the results of this study, it is noted that within the very remote context of limited SAE immersion, any ESL approach must include explicit modelling and teaching. This will provide the children with a contextual cultural linguistic framework upon which to establish and build their SAE ESL oracy. The very remote Aboriginal classroom is characteristically subjected to overtly formulaic and explicit periods of interaction throughout each day. Within the very remote context, teachers need to regularly program formal explicit periods in which a variety of formulaic sequences can be modelled and practiced by children every day. Teaching programs need to choreograph a range of habitualised experiences. These explicit activities must deliver opportunities for children to be exposed to, and experience a range of SAE ESL lessons that cover both the content and the communication strategies and other skills necessary to learn another language. Three recommendations arise from this study. First, further longitudinal research is necessary to complete this SAE ESL grammatical morpheme developmental profile. Second, a review of existing mandated SAE ESL profiles to include earlier emerging developmental indicators is warranted. Third, there is a need for development and systematic delivery across the NT of a professional and teaching learning package around early and emerging ESL oracy. This teaching package will be informed by evidence-based research on language acquisition that promotes best practice in ESL oracy for very remote children.

This ethnography analyses the circumstances of Aboriginal children attending a remote Australian school, in this case a private, segregated, two-culture school managed by Aboriginal Elders. Typically, Aboriginal children in segregated schools fail national achievement standards. This thesis examines factors affecting the physical, social, emotional and cultural wellbeing of Aboriginal children at one school. The post-colonial research aims to contribute to debates on ‘closing the gap’ in indigenous disadvantage and advances options for policy makers concerning the future of educational prioritisation of Aboriginal wellbeing. The researcher spent some months at the School and was immersed with reflexive awareness of epistemological assumptions, positionality, and ethics. The research involved 38 participants who work with about 200 children. The data include observations recorded at the School, interviews with all staff at the School and published research about Aboriginal children. The findings presented relate to the children’s wellbeing, carefully interpreted from the data. The data show that poor wellbeing affects these children’s capacity to participate in schooling, distracting them and others. Often under-trained, School staff are morally obliged to cater for children’s immediate needs, providing assistance for problems that are usually under control before children first attend school. The School adjusts the syllabus and complements western content with Aboriginal content, employing Aboriginal Elders and Aboriginal men to develop respect for indigenous ethics. The children’s parents and carers are, however, rarely supportive of School activities. Preparedness for formal education enables teachers to focus on the curriculum, modelling skills, behaviour and practices for the children’s future. When children are not ready, and their carers are not supportive, and the school, staff time and energy are drained by emergencies, little time is left for essential long-term education. The thesis argues that the children need more preparation before starting academic schooling. Programs to prepare both the children and their families can help. Policies that support schools and staff in radical adaptations of programs to better suit the children could include: behavioural practices in western society; emotional self-regulation; self-imagery as independent, important people; adjustment of school starting and finishing times (to suit the Aboriginal life-style); reduced number of school days per week (to match other NT schools operating on a 3-day fly-in-fly-out model), and developing materials in local languages that help Aboriginal people learn about western health threats and how to manage illnesses.

Otitis media and consequent hearing loss are known to be high in Koori communities. Previous research on otitis media in Koori communities has focused on its identification, treatment and management. Little research has focused on the prevention of otitis media. Victorian Aboriginal communities often have small populations which result in small sample sizes for research projects. Consequently use of traditional quantitative methods to measure of change arising from health interventions can be problematic. The aim of the research was to describe Koori children’s otitis media risk factors using a Koori research method in order to develop, implement and evaluate preventative interventions.

Research Doctorate - Doctor of Philosophy (PhD)
Wide disparities in health between Aboriginal and Torres Strait Islander and non-Indigenous Australians persist, with chronic diseases responsible for much of this gap. Type 2 diabetes is one of the key chronic diseases suffered by Aboriginal and Torres Strait Islander peoples, at a rate of at least 3.4 times that of non-Indigenous Australians. It is also a growing health problem for the non-Indigenous population and is associated with the increasing rates of obesity seen internationally over the past 10 to 20 years. Poor food habits and physical inactivity are the modifiable lifestyle risk factors for both type 2 diabetes and obesity. Little, however, little is known about these in Australian Aboriginal and Torres Strait Islander children or in rural children from disadvantaged areas in general. It is recognised that these risk factors track from childhood into adulthood, and that childhood offers an important opportunity to implement appropriate preventative health strategies. Appropriate programs to address poor food habits and physical inactivity cannot be developed without a thorough understanding of the risk factors pertinent to each population group. A search of the literature (Chapter 1) reveals that such information is very limited for Australian rural Aboriginal and Torres Strait Islander children and to a somewhat lesser extent for rural children in general, with evidence still very limited and little intervention research reported. Monitoring and evaluation of interventions to address risk factors require the use of validated population-level measurement tools. Currently, there are no such tools available for measuring Aboriginal and Torres Strait Islander children’s dietary intake and only one for measuring their physical activity. This severely compromises the capacity of health professionals to monitor this population’s health and to rigorously evaluate the effect of health strategies. There are urgent calls for research to evaluate the effect of interventions conducted in Aboriginal and Torres Strait Islander communities, with little evidence currently available in any field of health. In response to the issues raised above, the series of studies which constitute this thesis explores the physical activity characteristics and the food and nutrient intake of rural Aboriginal and Torres Strait Islander and non-Indigenous primary school-aged children (Chapters 3 and 5). The studies also validate a 7-day self-report physical activity recall questionnaire and a short food frequency questionnaire with the same populations (Chapters 2 and 4). Aboriginal and Torres Strait Islander children were found to provide self-report data regarding both physical activity and food intake that were at least as valid as those for non-Indigenous children, provided they received appropriate cultural support (detailed in the methods section of the relevant chapters). These results indicate that the measurement tools validated in this series of studies can be used with either group. All children were found to more than meet Australian guidelines for daily physical activity levels, with Aboriginal and Torres Strait Islander children demonstrating a tendency for higher activity than their non-Indigenous counterparts. All children who participated in this series of studies were found to possess excessive intakes of energy-dense nutrient-poor (EDNP) foods, with Aboriginal and Torres Strait Islander children demonstrating clinically important higher intakes than non-Indigenous children. Macro-nutrient and sodium intakes of Aboriginal and Torres Strait Islander children were significantly higher than those of their non-Indigenous counterparts. Finally, in response to findings of the studies, further research and intervention strategies are suggested in the conclusions (Chapter 6). A description of the community-controlled governance structure that guided and supported this program of research is provided.

This thesis presents a coherent body of research that investigates the theories that underpin the practice of welfare practitioners working with Aboriginal people in the New South Wales child protection system, and explores the impact of a professional training program built on trauma theory. The forcible separation of Indigenous children from their families as the result of past government policy and assimilation laws resulted in collective, historical and intergenerational trauma, which is evident in Aboriginal communities today. The concept of trauma provides a framework that gives a name to, and a language that makes sense of, the experience of the Stolen Generations and their descendants. At its core is the requirement that the stories of Indigenous people be heard, understood and ultimately acknowledged as trauma. Without an understanding of the dynamics of collective, historical and intergenerational trauma and an ability to respond appropriately to it, even the most wellmeaning practitioner is at risk of continuing to perpetrate trauma on successive generations of Indigenous children and their families. To date, the notion of collective, historical and intergenerational trauma has been slow to gain traction in relation to Indigenous people forcibly removed and their descendants. Indigenous people continue to experience judgement and blame for their ongoing disadvantage. The absence of an alternative narrative that acknowledges the traumatic experiences of Indigenous Australians means that racist attitudes and behaviours remain embedded consciously and unconsciously in the dominant culture. The significant over-representation of Indigenous children in the child protection sector makes it imperative that welfare practitioners receive high quality, ongoing training to support appropriate child protection practice and develop relevant trauma informed interventions. There is an urgency to ensure that training is not just provided, but is provided in a way that improves knowledge, skills and understanding, is rigorously evaluated, and leads to improved practice.