The Pediatrician’s Role in Optimizing School Readiness

Abstract

School readiness includes not only the early academic skills of children but also their physical health, language skills, social and emotional development, motivation to learn, creativity, and general knowledge. Families and communities play a critical role in ensuring children’s growth in all of these areas and thus their readiness for school. Schools must be prepared to teach all children when they reach the age of school entry, regardless of their degree of readiness. Research on early brain development emphasizes the effects of early experiences, relationships, and emotions on creating and reinforcing the neural connections that are the basis for learning. Pediatricians, by the nature of their relationships with families and children, may significantly influence school readiness. Pediatricians have a primary role in ensuring children’s physical health through the provision of preventive care, treatment of illness, screening for sensory deficits, and monitoring nutrition and growth. They can promote and monitor the social-emotional development of children by providing anticipatory guidance on development and behavior, by encouraging positive parenting practices, by modeling reciprocal and respectful communication with adults and children, by identifying and addressing psychosocial risk factors, and by providing community-based resources and referrals when warranted. Cognitive and language skills are fostered through timely identification of developmental problems and appropriate referrals for services, including early intervention and special education services; guidance regarding safe and stimulating early education and child care programs; and promotion of early literacy by encouraging language-rich activities such as reading together, telling stories, and playing games. Pediatricians are also well positioned to advocate not only for children’s access to health care but also for high-quality early childhood education and evidence-based family supports such as home visits, which help provide a foundation for optimal learning.

Parental Attitudes, Behaviors, and Barriers to School Readiness among Parents of Low-Income Latino Children

“…Society promotes school readiness [8,9,10] through the health and education systems. First, the child health system promotes physical and language development with near universal health coverage of children and pregnant women [11], as healthy children do better in school than children with acute or chronic disease [7,12].…”

“…Nearly 100% of low-income and minority children access routine health care at community clinics, yet there is no universal access to early education. While over one million low-income children attend Head Start annually [9], the most at risk children often do no enroll in preschool [4,5,22,23,24], struggle to access community resources [23,25], and ultimately, 80% will enter kindergarten behind their more advantaged peers [3,4,5,10,23]. …”

“…Community based pediatricians are uniquely positioned to improve school readiness given their unparalleled access to children who are at risk for not being ready for kindergarten [10,30]. Pediatricians also enjoy high levels of family trust, enabling them to support these families between ages 0–5.…”

“…Pediatricians also enjoy high levels of family trust, enabling them to support these families between ages 0–5. They have the opportunity to engage parents in SR and bridge the divide between the health and education systems to ensure all children are school ready [10]. Given the unique SR needs of low-income, Latino families and the relatively limited data on their perceived SR needs and barriers, we sought to understand how low-income, Latino parental attitudes, behaviors, and barriers in order to support their young children’s school readiness in a community based, pediatric clinic.…”

Development and Evaluation of a School Readiness Curriculum for Pediatrics Residents

“…4 The AAP recommends that pediatricians discuss school readiness with patients and families in clinic. 5 In order for pediatricians to fulfill this recommendation, they must understand the construct of school readiness, feel comfortable implementing an assessment and answering questions, and become knowledgeable about approaches to children who demonstrate weakness in one or more of the five prerequisite domains. The 3-year pediatrics residency is the primary opportunity for formal educational experiences for pediatricians-in-training.…”