American Academy of Pediatrics report details how many children start kindergarten with limitations that could have been reduced or eliminated earlier in life –– and what pediatricians and parents can do

Published: August 12, 2019 | Updated: February 23, 2021

An American Academy of Pediatrics (AAP) report in the August 2019 edition of Pediatrics says that too many U.S. children start kindergarten without adequate social, emotional, cognitive and physical development critical to school success. The article “School Readiness” features rapidly expanding research that shows how these gaps can be lowered or eliminated.

Providing developmentally sound and emotionally supportive early life experiences is vital to help improve school readiness for children, according to the AAP. These life experiences play a big role in how well children learn to manage their feelings, relate to and communicate with others, and enter school ready to learn. The AAP says research shows that school success is tied to better social, economic and health outcomes.

What is school readiness?

School readiness, as defined by the National Education Goals Panel, comprises the readiness of individual children for school and the school’s readiness for children, as well as the ability of the family and community to support early childhood development. School readiness in the child is defined as:

• Physical well-being and sensory motor development. This includes a child’s health status and growth.
• Social and emotional development.This includes a child’s self-regulation skills, attention, impulse control, capacity to limit aggressive and disruptive behaviors, and ability to take turns and cooperate, as well as the child’s empathy, ability to communicate emotions and identify and communicate feelings.
• Learning approaches.This includes a child’s enthusiasm, curiosity, temperament, culture and values.
• Language development.This includes a child’s speaking, vocabulary and literacy skills, including print awareness, story sense, and writing and drawing processes.
• General knowledge and cognition.This includes a child’s early literacy and math skills.

Research shows that school readiness is mostly determined by the health and well-being of a child’s family and his or her neighborhood, according to the AAP. Having consistent, emotionally supportive and age-appropriate early experiences can help children’s ability to learn and build resilience.

Achievement gaps still exist for children based on poverty, race and early childhood trauma. Less than half (48%) of children from low-income families are ready for school at age 5 compared with 75% of children from moderate- or high-income households. Children who have had two or more adverse childhood experiences (ACEs) are more than two times more likely to repeat a grade in school than peers without adverse experiences. ACEs include:

• A parent or guardian experiencing mental illness, substance abuse or incarceration
• Physical and/or emotional abuse
• Poverty
• Witnessing violence in the home or neighborhood
• Separation or death of a parent or loved one
• Divorcing parents

A pediatrician’s role in helping kids get school-ready

One key way parents and guardians can help their child get school-ready is making sure their child has access to health care. Healthy child development is supported by regular access to well-child visits. These visits allow pediatric health care providers to promote optimal nutrition, growth, development and physical and mental health.

The August report in Pediatrics reinforces a 2016 AAP policy, “The Pediatrician’s Role in Optimizing School Readiness.” The AAP states that pediatricians should work together with children and families to promote school readiness. A pediatrician can help a child get school-ready by:

• Helping families integrate activities that boost language and cognitive skills as well as parent-child bonds, such as reading, storytelling and playing games, into their daily lives.
• Educating parents and guardians about child development and behavior. Pediatricians can help parents learn how to address behavior concerns using positive discipline techniques as well as active parenting skills to help children build resilience.
• Screening for psychosocial risks and connecting families to evidence-based community resources. This can help reduce the stressful effects of ACEs.
• Monitoring and screening for developmental delays and disabilities such as autism as early as possible, and connecting families with early interventions that can have a positive impact on the child and his or her school readiness.
• Advocating for broad access to quality early childhood education for a child as well as the community he or she serves.

How Norton Children’s Medical Group addresses adverse childhood effects to get children school-ready

Norton Children’s Medical Group – Broadway partners with community organizations and programs to provide care for children and their families in the most underserved areas of Louisville.

“More than half of all children in Kentucky have experienced one or more adverse childhood experiences, including poverty,” said Becky S. Carothers, M.D., pediatrician with Norton Children’s Medical Group – Broadway. “Our practice looks to nurture children and families to help a child grow up strong, resilient and ready to succeed in school.”

Thanks to a gift from the Ulmer Family Foundation, the Ulmer Family Wellness Program was established to provide access to programming for all aspects of child and family health. Services include a social worker who can address behavioral health needs and family enrichment opportunities, such as parenting workshops, child care, safety supplies, books, bike helmets, car seats, baby care items and transportation vouchers. Norton Children’s Medical Group – Broadway is a Reach Out and Read site, promoting early literacy by providing age-appropriate books at well-child checkups from ages 2 months through 5 years.

The practice also is home to Dare to Care’s first Prescriptive Pantry, a food pantry located within a health care setting. Our providers can assist with food security and offer pantry food on-site to those who need it. This is coupled with conversations about how nutrition relates to health, and budget-friendly recipes developed by the office’s nutrition team.