Children who enter kindergarten healthy and ready to learn are more likely to succeed academically. Children at the highest risk for not being ready for school live in poverty and/or with chronic health conditions. High-quality early childhood education (ECE) programs can be used to help kids be ready for school; however, the United States lacks a comprehensive ECE system, with only half of 3- and 4-year-olds being enrolled in preschool, lagging behind 28 high-income countries. As addressing social determinants of health gains prominence in pediatric training and practice, there is increasing interest in addressing ECE disparities. Unfortunately, evidence is lacking for clinically based, early educational interventions. New interventions are being developed asynchronously in pediatrics and education, often without knowledge of the evidence base in the other’s literature. In this State-of-the-Art Review, we synthesize the relevant work from the field of education (searchable through the Education Resources Information Center, also known as the “PubMed” of education), combining it with relevant literature in PubMed, to align the fields of pediatrics and education to promote this timely transdisciplinary work. First, we review the education literature to understand the current US achievement gap. Next, we provide an update on the impact of child health on school readiness and explore emerging solutions in education and pediatrics. Finally, we discuss next steps for future transdisciplinary work between the fields of education and pediatrics to improve the health and school readiness of young children.

A child’s first 5 years are critical for healthy development. Multiple factors influence early child development, which impact a child’s overall life course.1,4 Experiencing early adversity, particularly living in poverty, may have profound consequences on child development.1,5,6 Fortunately, when families are provided with support and resources, developmental challenges can be improved and trajectories altered.3,7,15 

The fields of early childhood education (ECE) and pediatrics share a common goal of supporting optimal child development during the first 5 years of life. One measure of success is being ready to start kindergarten. The evidence is strong: being ready to start school is strongly correlated with less grade repetition, higher graduation rates, lower-risk behaviors, lower teenage pregnancy and incarceration rates, and better adult health outcomes.16,20 Unfortunately, many US children are not developmentally ready to start school, and the gap between low-income and minority students who are ready for school and their age-matched, upper-income peers is widening.20,30 Those in pediatrics and ECE concur that this gap is concerning but face challenges in working together to address these educational disparities.

The United States lacks a cohesive early childhood system. The only societal sector that enjoys contact with near 100% of young children before school entry is the health care system. Nearly all children are born in hospitals, and during the critical time of early brain development from 0 to 5 years of age, doctors have trusted31,33 and repeated contact with nearly all young children. Through frequent well-child encounters, the opportunity to improve rates of being ready to start school exists.28,34 However, pediatrics has not leveraged this unparalleled access to support the work of early childhood educators35,37 because of a paucity of evidence for clinically based ECE interventions. But a shift is underway. New approaches in pediatrics to support early child development are emerging as the science of early brain development drives innovation, but they are being developed asynchronously and in isolation, often without knowledge of existing evidence in the education literature. In this State-of-the-Art Review, we aim to synthesize the relevant work from education, combining it with relevant literature from pediatrics to (1) align the school readiness (SR) literature for a shared working language; (2) catalog key features of past and emerging school ready interventions; and (3) highlight the opportunity for better collaboration between the health and educational sectors to improve SR.

To bring insights from the field of education to the work of pediatrics and vice versa, we collaborated with faculty at the Stanford University Graduate School of Education to review early sentinel and more recent relevant work. We begin by delving into the following challenges: From education, we briefly synthesize critical literature to define the academic achievement gap and SR gap. From the field of pediatrics, we provide an update on the intersection of child health and optimal development for SR last reviewed in 200538: how does chronic illness and prematurity undermine child development in the early years? We then shift our focus to emerging solutions: From the field of education, we appraise the state of evidence-based, 0-to-5 early childhood interventions shown to support parents in maximizing child development. Next, the emerging pediatric response to the SR gap is reviewed. We conclude with (1) a discussion of future opportunities for collaboration between the pediatric and educational sectors to mitigate the SR gap, and (2) the promise and challenges of engaging in transdisciplinary work between these 2 fields to improve the development of young US children.

A significant barrier to collaboration between those in ECE and pediatrics is that shared ideas are discussed in different ways. We begin here by defining common concepts. In education, the academic achievement gap is defined as the difference on varying educational measures between subgroups of students (eg, race and/or ethnicity or socioeconomic status), allowing for disparities in the academic achievement of students across academic areas (eg, math, early reading ability, and third-grade reading levels) and nonacademic skills (eg, self-control) to be described.39,42 The term is further broken down into the “income achievement gap” (disparities in academic achievement between low-income and high-income students) and “racial and/or ethnic achievement gap,” including the "black-white achievement gap” (disparities in academic achievement between black and white students) and “Hispanic-white achievement gap” (disparities in academic achievement between Hispanic and white students). In this review, we default to the most specific terms possible to ensure clarity.

Multiple studies led to recognition of the academic achievement gap,39,42 with crucial contribution from the Early Childhood Longitudinal Study of a kindergarten class from 1998 into adulthood (Table 1).43,44 The Early Childhood Longitudinal Study revealed racial and/or ethnic and income achievement gaps in math and early reading for black and white students, for Hispanic and white students, and for low- and high-income students.24,45,46 

TABLE 1

The SR and Academic Achievement Gaps

GapSR Gap Reported as SDSource
SR measure (before or at kindergarten entry)  Measured as a difference in developmental measures between subgroups of students present before or at kindergarten entry   
 Cognitive skills before kindergarten entry Racial and/or ethnica  Hispanic-white gap: White children scored 0.73 SD higher on Bayley Scales of Infant and Toddler Development mental scores at 24 mo than Mexican-American toddlers from Spanish-speaking homes and 0.45 SD higher than Hispanic toddlers in English-speaking homes. Fuller et al47; Fuller and García Coll48  
   Hispanic-white gap: Mexican-American children show significantly lower math-concepts knowledge at 48 mo relative to white children. Guerrero et al49  
 Early academic skills at kindergarten entry (math and reading) Racial and/or ethnica  Black-white gap: Black children perform ∼0.3–0.5 SD lower on math and reading assessments compared with white children (math 0.55 SD; reading 0.32 SD). Fryer and García Coll48; Reardon40; Reardon and Portilla24  
   Hispanic-white gap: Hispanic children perform ∼0.5–0.6 SD lower on math and reading assessments compared with white children (math 0.67 SD; reading 0.56 SD). 
 Incomeb  Children from lower incomes (10th percentile) perform ∼1.1 SD lower on math and reading assessments compared with children from a higher income (90th percentile): math 1.17 SD and reading 1.06 SD. Reardon and Portilla24  
 Social-emotional SR at kindergarten entry (self-control, approaches to learning, externalizing behavior) Racial and/or ethnic  Black-white gap: Black children perform ∼0.3 SD lower across social-emotional developmental measures compared with white children: Self-control 0.32 SD, approaches to learning 0.27 SD, externalizing behaviors 0.29 SD, and attention and engagement 0.36 SD. Reardon and Portilla24; Garcia and Weiss4  
   Hispanic-white gap: The gap between Hispanic and white children on social-emotional developmental measures is negligible: Self-control 0.09 SD, approaches to learning 0.11 SD, and externalizing behaviors −0.03 SD. Reardon and Portilla24; Garcia and Weiss4  
 Income  Children from lower incomes (10th percentile) perform ∼0.5 SD lower across social- emotional development measures compared with children from a higher income (90th percentile): Self-control 0.4–0.5 SD, approaches to learning 0.5–0.6 SD, externalizing behaviors 0.4 SD, and attention and engagement 0.63 SD. Reardon and Portilla24; Garcia and Weiss4  
Educational measure  Academic achievement gap: Measured as a difference on an educational measure between subgroups of students  
 Math (National Assessment of Educational Progress) Racial and/or ethnic  Black-white gap: In 2007, the national black-white mathematics gap was 26 pointsc in grade 4 and 31 points in grade 8. White students had average scores of 26 points higher in fourth grade and 31 points higher in eighth grade than black students on a 0-to-500 scale. Vanneman et al42  
   Hispanic-white gap: In 2009, the national Hispanic-white mathematics gap was 21 points in grade 4 and 26 points in grade 8. White students had average scores of 21 points higher in fourth grade and 26 points higher in eighth grade than Hispanic students on a 0-to-500 scale. Hemphill and Vanneman39  
 Income  In 2011, the national income mathematics gap was 24 points in grade 4 and 28 points in grade 8. Students from higher incomes (ineligible for free lunch) had average scores 24 points higher in fourth grade and 28 points higher in eighth grade than students from lower incomes (eligible for free lunch) on a 0-to-500 scale. National Center for Education Statistics45,46  
 Reading (National Assessment of Educational Progress) Racial and/or ethnic  Black-white gap: In 2007, the national black-white reading gap was 27 points in grade 4 and 26 points in grade 8. White students had average scores of 27 points higher in fourth grade and 26 points higher in eighth grade than black students on a 0-to-500 scale. Vanneman et al42  
   Hispanic-white gap: In 2009, the national Hispanic-white reading gap was 25 points in grade 4 and 24 points in grade 8. White students had average scores of 25 points higher in fourth grade and 24 points higher in eighth grade than Hispanic students on a 0-to-500 scale. Hemphill and Vanneman39  
 Income  In 2011, the national income reading gap was 29 points in grade 4 and 28 points in grade 8. Students from higher incomes (ineligible for free lunch) had average scores 24 points higher in fourth grade and 28 points higher in eighth grade than students from lower incomes (eligible for free lunch) on a 0-to-500 scale. National Center for Education Statistics46  
GapSR Gap Reported as SDSource
SR measure (before or at kindergarten entry)  Measured as a difference in developmental measures between subgroups of students present before or at kindergarten entry   
 Cognitive skills before kindergarten entry Racial and/or ethnica  Hispanic-white gap: White children scored 0.73 SD higher on Bayley Scales of Infant and Toddler Development mental scores at 24 mo than Mexican-American toddlers from Spanish-speaking homes and 0.45 SD higher than Hispanic toddlers in English-speaking homes. Fuller et al47; Fuller and García Coll48  
   Hispanic-white gap: Mexican-American children show significantly lower math-concepts knowledge at 48 mo relative to white children. Guerrero et al49  
 Early academic skills at kindergarten entry (math and reading) Racial and/or ethnica  Black-white gap: Black children perform ∼0.3–0.5 SD lower on math and reading assessments compared with white children (math 0.55 SD; reading 0.32 SD). Fryer and García Coll48; Reardon40; Reardon and Portilla24  
   Hispanic-white gap: Hispanic children perform ∼0.5–0.6 SD lower on math and reading assessments compared with white children (math 0.67 SD; reading 0.56 SD). 
 Incomeb  Children from lower incomes (10th percentile) perform ∼1.1 SD lower on math and reading assessments compared with children from a higher income (90th percentile): math 1.17 SD and reading 1.06 SD. Reardon and Portilla24  
 Social-emotional SR at kindergarten entry (self-control, approaches to learning, externalizing behavior) Racial and/or ethnic  Black-white gap: Black children perform ∼0.3 SD lower across social-emotional developmental measures compared with white children: Self-control 0.32 SD, approaches to learning 0.27 SD, externalizing behaviors 0.29 SD, and attention and engagement 0.36 SD. Reardon and Portilla24; Garcia and Weiss4  
   Hispanic-white gap: The gap between Hispanic and white children on social-emotional developmental measures is negligible: Self-control 0.09 SD, approaches to learning 0.11 SD, and externalizing behaviors −0.03 SD. Reardon and Portilla24; Garcia and Weiss4  
 Income  Children from lower incomes (10th percentile) perform ∼0.5 SD lower across social- emotional development measures compared with children from a higher income (90th percentile): Self-control 0.4–0.5 SD, approaches to learning 0.5–0.6 SD, externalizing behaviors 0.4 SD, and attention and engagement 0.63 SD. Reardon and Portilla24; Garcia and Weiss4  
Educational measure  Academic achievement gap: Measured as a difference on an educational measure between subgroups of students  
 Math (National Assessment of Educational Progress) Racial and/or ethnic  Black-white gap: In 2007, the national black-white mathematics gap was 26 pointsc in grade 4 and 31 points in grade 8. White students had average scores of 26 points higher in fourth grade and 31 points higher in eighth grade than black students on a 0-to-500 scale. Vanneman et al42  
   Hispanic-white gap: In 2009, the national Hispanic-white mathematics gap was 21 points in grade 4 and 26 points in grade 8. White students had average scores of 21 points higher in fourth grade and 26 points higher in eighth grade than Hispanic students on a 0-to-500 scale. Hemphill and Vanneman39  
 Income  In 2011, the national income mathematics gap was 24 points in grade 4 and 28 points in grade 8. Students from higher incomes (ineligible for free lunch) had average scores 24 points higher in fourth grade and 28 points higher in eighth grade than students from lower incomes (eligible for free lunch) on a 0-to-500 scale. National Center for Education Statistics45,46  
 Reading (National Assessment of Educational Progress) Racial and/or ethnic  Black-white gap: In 2007, the national black-white reading gap was 27 points in grade 4 and 26 points in grade 8. White students had average scores of 27 points higher in fourth grade and 26 points higher in eighth grade than black students on a 0-to-500 scale. Vanneman et al42  
   Hispanic-white gap: In 2009, the national Hispanic-white reading gap was 25 points in grade 4 and 24 points in grade 8. White students had average scores of 25 points higher in fourth grade and 24 points higher in eighth grade than Hispanic students on a 0-to-500 scale. Hemphill and Vanneman39  
 Income  In 2011, the national income reading gap was 29 points in grade 4 and 28 points in grade 8. Students from higher incomes (ineligible for free lunch) had average scores 24 points higher in fourth grade and 28 points higher in eighth grade than students from lower incomes (eligible for free lunch) on a 0-to-500 scale. National Center for Education Statistics46  

Racial and/or ethnic and income disparities in US children’s academic achievement exist before school entry and persist throughout primary and secondary school. This table is not meant to be comprehensive; we provide key references from the field of education to demonstrate the achievement and SR gaps.

a

The black-white achievement gap refers to disparities in academic achievement between black and white students; the Hispanic-white achievement gap refers to disparities in academic achievement between Hispanic and white students.

b

Disparities in academic achievement between students from low-income and high-income families.

c

The National Assessment of Educational Progress is an annual assessment across content subjects with scores reported on a 0-to-500–point scale. The gaps shown are the difference between the average score for the 2 subgroups.

Racial and/or ethnic and income gaps in early childhood development exist before school entry and are referred to as the SR gap. Pediatrics and ECE generally overlap, and those in the fields define SR as a child’s optimal development in 5 similar domains2,50,51 (Table 2) when compared with education researchers, who often assess 1 domain (eg, cognition) and less frequently consider SR as a whole.52,56 Finally, international public health fields include children’s SR and the parents’ and communities’ readiness for school.57 As a result, there is no common language for defining, measuring, and discussing SR in collaborative work. On the basis of current definitions in the literature, we reconciled SR definitions and for the purpose of this review refer to SR as a child’s development across 5 domains: (1) cognitive development, (2) physical development, (3) language development, (4) social-emotional development, and (5) approaches to learning (Table 2).2,50,51 

TABLE 2

Understanding SR: Definitions Across Fields to Create a Shared Definition

SR in Clinical PediatricsSR in ECESR in Educational and Pediatric ResearchSR in International and/or Public HealthSR in this SOTA
Bright Futures states “the child will be challenged to demonstrate developmental capacities, including”2 the following: HS Early Learning Outcomes Framework45Historically, researchers have assessed a range of dimensions of SR because no consistent metric of “overall” SR exists: UNICEF states “the 3 dimensions of school readiness are”55 the following: SR in this SOTA review combines the domains from ECE with components in clinical pediatrics for a shared definition. SR is a child being ready for kindergarten across 5 developmental domains: 
 (1) Language and speech sufficient for communication and learning  (1) Approaches to learning  (1) Approaches to learning: Whether students have the tools necessary to work effectively in a classroom setting50   (1) Ready children, focusing on children’s learning and development  (1) Cognitive development (abilities such as memory and early math skills) 
 (2) Cognitive abilities necessary for learning sound: Letter associations, spatial relations, and number concepts  (2) Social emotional development  (2) Cognitive achievement: Performance in math, reading, or general knowledge51,54   (2) Ready schools, focusing on the school environment along with practices that foster and support a smooth transition for children into primary school and advance and promote the learning of all children  (2) Physical development (including child health and nutrition, gross and fine motor skills, perception, vision, and hearing) 
 (3) Ability to separate from family and caregivers  (3) Language and communication  (3) Maturation and social emotional development52   (3) Ready families, focusing on parental and caregiver attitudes and involvement in their children’s early learning, and development and transition to school  (3) Language development (speech, communication, and literacy) 
 (4) Self-regulation with respect to behavior, emotions, attention, and motor movement  (4) Cognition  (4) Academic domains and process of learning: What children are expected to know and do in a variety of academic domains and processes of learning before entering a formal classroom setting53    (4) Social-emotional development (emotional health, relationships with adults and children) 
 (5) Ability to make friends and get along with peers  (5) Perceptual, motor, and physical development    (5) Approaches to learning (self-regulation [following class rules and group participation] and executive functioning [impulse control and focus, initiative, and curiosity]) 
 (6) Ability to participate in group activities     
 (7) Ability to follow rules and directions     
    
 (8) Skills that others appreciate, such as singing or drawing     
    
Pediatric providers promote SR by assessing and monitoring: US Department of Education Essential Domains of SR46   
 • General health, including vision and hearing  (1) Language and literacy development    
 • Child’s developmental trajectory  (2) Cognition and general knowledge (including early mathematics and early scientific development)    
 • Emotional health of the child and family based on long-term child-family relationships  (3) Approaches toward learning    
 • Child’s social development, skills, and difficulties  (4) Physical well-being and motor development    
 • Specific child-based, family-based, school-based, and community-based risk factors  (5) Social and emotional development    
SR in Clinical PediatricsSR in ECESR in Educational and Pediatric ResearchSR in International and/or Public HealthSR in this SOTA
Bright Futures states “the child will be challenged to demonstrate developmental capacities, including”2 the following: HS Early Learning Outcomes Framework45Historically, researchers have assessed a range of dimensions of SR because no consistent metric of “overall” SR exists: UNICEF states “the 3 dimensions of school readiness are”55 the following: SR in this SOTA review combines the domains from ECE with components in clinical pediatrics for a shared definition. SR is a child being ready for kindergarten across 5 developmental domains: 
 (1) Language and speech sufficient for communication and learning  (1) Approaches to learning  (1) Approaches to learning: Whether students have the tools necessary to work effectively in a classroom setting50   (1) Ready children, focusing on children’s learning and development  (1) Cognitive development (abilities such as memory and early math skills) 
 (2) Cognitive abilities necessary for learning sound: Letter associations, spatial relations, and number concepts  (2) Social emotional development  (2) Cognitive achievement: Performance in math, reading, or general knowledge51,54   (2) Ready schools, focusing on the school environment along with practices that foster and support a smooth transition for children into primary school and advance and promote the learning of all children  (2) Physical development (including child health and nutrition, gross and fine motor skills, perception, vision, and hearing) 
 (3) Ability to separate from family and caregivers  (3) Language and communication  (3) Maturation and social emotional development52   (3) Ready families, focusing on parental and caregiver attitudes and involvement in their children’s early learning, and development and transition to school  (3) Language development (speech, communication, and literacy) 
 (4) Self-regulation with respect to behavior, emotions, attention, and motor movement  (4) Cognition  (4) Academic domains and process of learning: What children are expected to know and do in a variety of academic domains and processes of learning before entering a formal classroom setting53    (4) Social-emotional development (emotional health, relationships with adults and children) 
 (5) Ability to make friends and get along with peers  (5) Perceptual, motor, and physical development    (5) Approaches to learning (self-regulation [following class rules and group participation] and executive functioning [impulse control and focus, initiative, and curiosity]) 
 (6) Ability to participate in group activities     
 (7) Ability to follow rules and directions     
    
 (8) Skills that others appreciate, such as singing or drawing     
    
Pediatric providers promote SR by assessing and monitoring: US Department of Education Essential Domains of SR46   
 • General health, including vision and hearing  (1) Language and literacy development    
 • Child’s developmental trajectory  (2) Cognition and general knowledge (including early mathematics and early scientific development)    
 • Emotional health of the child and family based on long-term child-family relationships  (3) Approaches toward learning    
 • Child’s social development, skills, and difficulties  (4) Physical well-being and motor development    
 • Specific child-based, family-based, school-based, and community-based risk factors  (5) Social and emotional development    

SOTA, state-of-the-art review article; UNICEF, United Nations Children’s Fund.

Studies reveal income SR gaps in approaches to learning such as self-control between low- and high-income children4 and racial and/or ethnic SR gaps in language and cognitive development between Hispanic and white students.47,49 SR gaps are consequential given that early academic skills are strong predictors of future academic success even when adjusting for ability and behavior,16 and SR gaps that are evident in kindergarten tend to persist throughout school.58,62 Some estimate that the black-white test score gap at the end of high school could be reduced by at least half if the gap were eliminated at school entry.63 

Although academic achievement and SR gaps are striking, improvements are also evident. Some academic achievement gaps narrowed.24 For example, from 1998 to 2010, the black-white, Hispanic-white, and income achievement gaps in math declined despite recent increases in income inequality.24 These changes correspond with improvements in early childhood experiences and alterations in parenting behaviors, particularly for lower-income children, with increases in books and reading in the home, access to educational games on computers, and interactions between parents and children during this period.64 

High-quality preschool programs help narrow the SR gap. Participation in preschool has increased over time because of substantial public investment through federal and state preschool programs, such as Head Start (HS).65,68 Although preschool enrollment increased for all groups from 1970 to 2010, a sizable gap remains between high- and low-income families in the percentage of children who are enrolled.69 Today, only 54% of 3- and 4-year-old US children are enrolled in preschool,70,71 and ∼2.5 million 4-year-old children lack access to publicly funded preschool programs.67 Pediatricians must work with those in ECE and local communities to close that gap and provide parenting support to maximize early child development.34,36 

There is limited research on how acute and chronic diseases impact young children’s early development and to what extent poverty further undermines development. In a 2005 review, Currie38 summarized the existing evidence collected by researchers who explored how poor child health contributes to racial and/or ethnic and income SR gaps. In this section, we provide an update on the impact that neonatal and chronic illnesses have on early development, which is essential to the shared definition of SR (Table 3).

TABLE 3

The Impact of Child Health Conditions on SR: (1) Cognitive Development, (2) Physical Development, (3) Language Development, (4) Social-Emotional Development, and (5) Approaches to Learning

Child Health ConditionSR Developmental Outcomes (1–5)Source
Prematurity and early life exposures   
 Low-birth wt Cognitive impairments: Black women are twice as likely as white women to have low birth wt infants and subsequent cognitive impairment; the author estimates low birth wt accounts for ∼4% of the racial disparity in SR. Reichman72  
 VLBW SR gap: VLBW neonates with parents with a high school degree are more likely to be ready for school and require less special education services at age 5 years than those with parents with less than a high school degree. Bauer and Msall73; Patrianakos-Hoobler et al74,75  
 Prematurity or gestational age Cognitive and physical impairments: Neonates who are born prematurely have higher rates of cerebral palsy, intellectual disability, and/or visual or hearing disabilities; this leads to more special education needs at kindergarten entry. However, most have mastered basic skills in mobility, self-care, and social cognition by school entry. Bauer and Msall73,76; Patrianakos-Hoobler et al75  
 Social emotional and approaches to learning impairments: Neonates who are born prematurely have more teacher-reported behavior problems and internalizing and attention disorders and struggle in 1 or more SR domains at kindergarten entry. VLBW infants with typical early development are still at risk regarding cognitive flexibility, nonverbal working memory, and planning. Bauer and Msall73  
 SR gap: Neonates who are born prematurely have lower reading and math scores in kindergarten. Association between gestational age and poor SR for reading and math is seen, with the suggestion of a threshold effect in children born at ≥32 wk gestation. Shah et al77  
 RDS Risk factors for low SR: The most powerful factor for low SR is low SES, followed by male sex, chronic lung disease, and severe intraventricular hemorrhage. Patrianakos-Hoobler et al74  
 Cognitive impairment: Of children with RDS requiring ventilation and surfactant, by age 2 y, 11% were disabled and 23% developmentally delayed. At age 5 y and 6 mo, 11% required intensive special education, and 21% required some special education. Overall, disability and delay at age 2 y was 92% and 50% predictive, respectively, of a lack of SR at age 5 y. Patrianakos-Hoobler et al75  
 Cognitive impairment: Children with delay at 2 y are more likely to need special education if they are of low SES. — 
 LPTs Developmental delays, lower IQ, lower SR: Infants born 34–36 wk gestation (LPT) have higher rates of cerebral palsy, higher rates of mental retardation, lower IQ scores, lower reading and math proficiency at school entry, and overall more teacher-reported behavior problems compared with term infants. ECLS-B study revealed that LPTs who are developmentally delayed at 24 mo have increased odds of impairment at school age (5 y). In multivariable analysis, LPTs had higher odds of worse total SR scores (adjusted odds ratio 1.52 [95% confidence interval 1.06–2.18]; P = .02). Many improved their performance by age 5 y; those less likely to improve by 5 y were of low SES, had primary language other than English, were black, and had low maternal education.a Woythaler et al78  
 Neonatal encephalopathy associated with birth asphyxia No impact on development: Children with mild neonatal encephalopathy associated with term birth asphyxia performed well on psychoeducational SR tests compared with children who are not disabled with moderate encephalopathy. Those with mild encephalopathy and no disabilities had normal and/or average performance on SR tests (1992). Robertson and Finer79; Robertson and Grace77  
 Lower SR: Term infants with moderate encephalopathy with multiple antiepileptic drugs and abnormal neurologic exams in the ICU were positive predictors of lower SR at age 5.5 y (1988). No significant differences were due to social variables. Those with moderate encephalopathy may benefit from special preschool evaluation and modified early school interventions despite no significant disability that would qualify them for EI. — 
 IUDE Cognitive impairments (inattention and focusing): No association was found between IQ and SR skills; higher scores on inattentive skills and lower scores on focusing between IUDE children (n = 103) and non–IUDE-exposed children (n = 33) at age 4 y were seen. For both groups, a lack of preschool and low maternal education was associated with lower SR.a Butz et al80  
Poor school performance and SR: A descriptive review revealed that children with prenatal illicit opioid exposure had poorer performance on measures of language, verbal ability, mathematics, reading, impulse control, and SR skills. Jain et al81  
Acute illnesses   
 AOM and/or ear infection Cognitive and behavior problems: AOM is common and often self resolves; but persistent effusions can impact hearing, language development, SR, and academic achievement (see chronic AOM). Currie38; Eiserman et al82  
 Hearing screening: Hearing screening from birth to 3 y is often subjective. Otoacoustic emission testing is more sensitive and should be combined with clear screening and consultant with a pediatric audiologist in screening programs.  
 OME and/or ear infection Hearing, cognitive (math), and language delays: Black children (managed from 6 mo to 5 y of age); those with OME and hearing loss had a small association with expressive language delay, although not significant when corrected for SES, maternal education, and home environment. However, children with more episodes of OME scored lower in verbal math problems. Children with more hearing loss scored lower in math and recognizing incomplete words. Those with recurrent or more OME had lower SR measures. Home environment and SES were the strongest factors in academic outcomes.a Roberts et al83  
Chronic illnesses   
 Chronic AOM Developmentally at risk across domains: Developmentally normal children with chronic AOM are 1.28–1.35 times more likely to be developmentally at risk in physical well-being, social competence, emotional maturity, communication skills, and general knowledge. Bell et al84  
 Asthma or chronic respiratory disease Cognitive, social-emotional, and physical development risk: Asthma remains the No. 1 reason for emergency department visits, with a higher prevalence in black and Hispanic children. These children have higher hospitalization rates, more school absences, less disease control, higher rates of grade retention (18%), more learning disabilities, and lower kindergarten entry scores. Those with severe asthma require more support in school. Currie38  
 SR skills: Urban preschool children with “asthma with limitation” had lower scores on SR skills compared with children without asthma (2.0 vs 2.5; P < .001). Parents are also more likely to report that children need help with learning. Halterman et al85  
 Physical and social-emotional development: School-aged children with chronic disease have increased odds of developmental vulnerability in physical wellbeing and social competence. Bell et al84  
 Epilepsy No impact on development: Children 5–6 y of age with epilepsy had no significant developmental vulnerabilities compared with those with no chronic illness. Bell et al84  
 ADHD Social-emotional impairment (behavior problems, grade retention): Children with ADHD are more likely to struggle with basic school tasks (sitting still and listening); have lower SR, math, and reading scores; more disruptive behavior and difficulty taking turns; and higher grade retention and need for special education services. This is more common in children of low SESa (income <$20 000) and black boys (although whites evaluate more than blacks). Parent barriers for black children include stigma and financial constraints. Currie38  
 Cognitive difficulties in preschool: Preschool children with ADHD symptoms (assessed in teacher and parent interviews) were more likely to have lower cognitive scores around abstract thinking, critical reasoning, and visual and motor skills. Children with ADHD symptoms were 5 times as likely to have compromised organizational skills. Thomaidis et al86  
 Allergies Cognitive and behavioral problems: Children with allergies (seasonal, hay fever, respiratory, or other) can have cognitive and behavioral problems. Currie38  
 SDB Cognitive and school performance impairments: Pediatric SDB, such as obstructive sleep apnea, has substantial adverse effects on cognition and school performance, with daytime behavioral comorbidities being the most significant (daytime sleepiness, hyperactivity, restlessness). Preschool children at risk for SDB who snored “frequently” or “almost always” had lower executive functioning. Karpinski et al87  
 Sleep duration Lower development scores in multiple domains: Chinese preschool children (N = 553; mean age 5.46 y), parent-reported daily sleep over a wk, only 11% with recommended 11–12 h per night. Those with sleep deprivation (<7 h per night) had lower total scores on the Chinese Early Development Instrument total scores in emotional maturity, language and/or cognitive and prosocial behaviors and higher scores in hyperactivity and/or inattention. Children were not screened for snoring or SBD risk factors. Sleep deprivation was more likely in low-SES homes, with lower maternal education,a and in children who used devices >3 h per d. Tso et al88  
 Lower SR: Israeli children who were unqualified (not school ready) for first grade compared with control children had shorter sleep durations, reduced sleep efficiency, increased nighttime awakenings, and more disordered sleep, insomnia, and hypersomnia. Ravid et al89  
 Dental caries Cognitive impairment and behavior problems: Chronic pain from caries impacts behavior, attention, learning, and school attendance. Caries that go untreated impact language development due to issues eating and speaking and/or learning. Children are more likely to have untreated caries if they are Hispanic or black. Currie38; CDC88  
 Malnutrition Increased risk of lead poisoning: Children with malnutrition are more likely to have anemia and absorb more lead, which puts them at higher risk for lead poisoning. Malnutrition is more common in children who are poor because of food insecurity and a lack of access to micronutrients. Currie38  
Special conditions   
 SCA Lower SR scores: Small case-control study of 4–6 y olds; those with SCA had lower scores in multiple domains on the Pediatric Examination of Educational Readiness and normal intelligence on McCarthy Scales of Children’s Abilities. Chua-Lim et al90  
 Language development: Small study; kindergarten children with SCA scored lower than matched controls on the Developing Skills Checklist in auditory discrimination and language. Steen et al91  
 Cerebral palsy Communication and social-emotional development: preschool-aged children (4–5 y) with cerebral palsy performed significantly below their peers in 3 of 5 key readiness-to-learn skill areas, including mobility, self-care, social function, and communication abilities on the Pediatric Evaluation of Disability Inventory. Gehrmann et al92  
 Pediatric Evaluation of Disability Inventory and communication using the Communication and Symbolic Behavior Scales Developmental Profile: Fifty-five percent of children demonstrated significantly delayed communication skills. These children qualify for EI in the United States, but no similar services exist in Australia for those <6 y of age. — 
Environmental exposures and hazards   
 Poor housing Poor housing and poor air quality are associated with higher rates of asthma.a Currie38  
 Lead poisoning Cognitive and behavioral impairments: Lead exposure is associated with lower IQ and more ADHD; black children are impacted more than white children. Poor areas have a higher incidence of lead exposure (historically through paint, gasoline, water, canned food; today through old pipes, residual in soil, and paint in old homes).a Currie38  
 IDA No impact on development: The incidence of IDA has decreased over time even in children who are disadvantaged because of iron-fortified formula and cereals and supplemental nutrition obtained through the WIC program. Little evidence exists to suggest IDA impacts cognitive development or SR. Currie38  
Maternal factors   
 Maternal depression Cognitive and social-emotional development: Maternal depression changes parent discipline (more physical force, less positive interactions) and worsens child outcomes, including more behavior problems, insecure attachment, cognitive problems, and reduced test scores by 0.33 SDs. Higher rates of prenatal depression and postpartum depression are seen in mothers who are poor.a Currie38  
 Breast feeding Promotes cognitive development: White women are more likely than black women to breastfeed (70% vs 40%, respectively). Breastfeeding supports cognitive development through disease prevention (less asthma, fewer ear infections); high long-chain fatty acid content supports brain development and increases infant-mother bonding and child’s IQ. Currie38  
Child Health ConditionSR Developmental Outcomes (1–5)Source
Prematurity and early life exposures   
 Low-birth wt Cognitive impairments: Black women are twice as likely as white women to have low birth wt infants and subsequent cognitive impairment; the author estimates low birth wt accounts for ∼4% of the racial disparity in SR. Reichman72  
 VLBW SR gap: VLBW neonates with parents with a high school degree are more likely to be ready for school and require less special education services at age 5 years than those with parents with less than a high school degree. Bauer and Msall73; Patrianakos-Hoobler et al74,75  
 Prematurity or gestational age Cognitive and physical impairments: Neonates who are born prematurely have higher rates of cerebral palsy, intellectual disability, and/or visual or hearing disabilities; this leads to more special education needs at kindergarten entry. However, most have mastered basic skills in mobility, self-care, and social cognition by school entry. Bauer and Msall73,76; Patrianakos-Hoobler et al75  
 Social emotional and approaches to learning impairments: Neonates who are born prematurely have more teacher-reported behavior problems and internalizing and attention disorders and struggle in 1 or more SR domains at kindergarten entry. VLBW infants with typical early development are still at risk regarding cognitive flexibility, nonverbal working memory, and planning. Bauer and Msall73  
 SR gap: Neonates who are born prematurely have lower reading and math scores in kindergarten. Association between gestational age and poor SR for reading and math is seen, with the suggestion of a threshold effect in children born at ≥32 wk gestation. Shah et al77  
 RDS Risk factors for low SR: The most powerful factor for low SR is low SES, followed by male sex, chronic lung disease, and severe intraventricular hemorrhage. Patrianakos-Hoobler et al74  
 Cognitive impairment: Of children with RDS requiring ventilation and surfactant, by age 2 y, 11% were disabled and 23% developmentally delayed. At age 5 y and 6 mo, 11% required intensive special education, and 21% required some special education. Overall, disability and delay at age 2 y was 92% and 50% predictive, respectively, of a lack of SR at age 5 y. Patrianakos-Hoobler et al75  
 Cognitive impairment: Children with delay at 2 y are more likely to need special education if they are of low SES. — 
 LPTs Developmental delays, lower IQ, lower SR: Infants born 34–36 wk gestation (LPT) have higher rates of cerebral palsy, higher rates of mental retardation, lower IQ scores, lower reading and math proficiency at school entry, and overall more teacher-reported behavior problems compared with term infants. ECLS-B study revealed that LPTs who are developmentally delayed at 24 mo have increased odds of impairment at school age (5 y). In multivariable analysis, LPTs had higher odds of worse total SR scores (adjusted odds ratio 1.52 [95% confidence interval 1.06–2.18]; P = .02). Many improved their performance by age 5 y; those less likely to improve by 5 y were of low SES, had primary language other than English, were black, and had low maternal education.a Woythaler et al78  
 Neonatal encephalopathy associated with birth asphyxia No impact on development: Children with mild neonatal encephalopathy associated with term birth asphyxia performed well on psychoeducational SR tests compared with children who are not disabled with moderate encephalopathy. Those with mild encephalopathy and no disabilities had normal and/or average performance on SR tests (1992). Robertson and Finer79; Robertson and Grace77  
 Lower SR: Term infants with moderate encephalopathy with multiple antiepileptic drugs and abnormal neurologic exams in the ICU were positive predictors of lower SR at age 5.5 y (1988). No significant differences were due to social variables. Those with moderate encephalopathy may benefit from special preschool evaluation and modified early school interventions despite no significant disability that would qualify them for EI. — 
 IUDE Cognitive impairments (inattention and focusing): No association was found between IQ and SR skills; higher scores on inattentive skills and lower scores on focusing between IUDE children (n = 103) and non–IUDE-exposed children (n = 33) at age 4 y were seen. For both groups, a lack of preschool and low maternal education was associated with lower SR.a Butz et al80  
Poor school performance and SR: A descriptive review revealed that children with prenatal illicit opioid exposure had poorer performance on measures of language, verbal ability, mathematics, reading, impulse control, and SR skills. Jain et al81  
Acute illnesses   
 AOM and/or ear infection Cognitive and behavior problems: AOM is common and often self resolves; but persistent effusions can impact hearing, language development, SR, and academic achievement (see chronic AOM). Currie38; Eiserman et al82  
 Hearing screening: Hearing screening from birth to 3 y is often subjective. Otoacoustic emission testing is more sensitive and should be combined with clear screening and consultant with a pediatric audiologist in screening programs.  
 OME and/or ear infection Hearing, cognitive (math), and language delays: Black children (managed from 6 mo to 5 y of age); those with OME and hearing loss had a small association with expressive language delay, although not significant when corrected for SES, maternal education, and home environment. However, children with more episodes of OME scored lower in verbal math problems. Children with more hearing loss scored lower in math and recognizing incomplete words. Those with recurrent or more OME had lower SR measures. Home environment and SES were the strongest factors in academic outcomes.a Roberts et al83  
Chronic illnesses   
 Chronic AOM Developmentally at risk across domains: Developmentally normal children with chronic AOM are 1.28–1.35 times more likely to be developmentally at risk in physical well-being, social competence, emotional maturity, communication skills, and general knowledge. Bell et al84  
 Asthma or chronic respiratory disease Cognitive, social-emotional, and physical development risk: Asthma remains the No. 1 reason for emergency department visits, with a higher prevalence in black and Hispanic children. These children have higher hospitalization rates, more school absences, less disease control, higher rates of grade retention (18%), more learning disabilities, and lower kindergarten entry scores. Those with severe asthma require more support in school. Currie38  
 SR skills: Urban preschool children with “asthma with limitation” had lower scores on SR skills compared with children without asthma (2.0 vs 2.5; P < .001). Parents are also more likely to report that children need help with learning. Halterman et al85  
 Physical and social-emotional development: School-aged children with chronic disease have increased odds of developmental vulnerability in physical wellbeing and social competence. Bell et al84  
 Epilepsy No impact on development: Children 5–6 y of age with epilepsy had no significant developmental vulnerabilities compared with those with no chronic illness. Bell et al84  
 ADHD Social-emotional impairment (behavior problems, grade retention): Children with ADHD are more likely to struggle with basic school tasks (sitting still and listening); have lower SR, math, and reading scores; more disruptive behavior and difficulty taking turns; and higher grade retention and need for special education services. This is more common in children of low SESa (income <$20 000) and black boys (although whites evaluate more than blacks). Parent barriers for black children include stigma and financial constraints. Currie38  
 Cognitive difficulties in preschool: Preschool children with ADHD symptoms (assessed in teacher and parent interviews) were more likely to have lower cognitive scores around abstract thinking, critical reasoning, and visual and motor skills. Children with ADHD symptoms were 5 times as likely to have compromised organizational skills. Thomaidis et al86  
 Allergies Cognitive and behavioral problems: Children with allergies (seasonal, hay fever, respiratory, or other) can have cognitive and behavioral problems. Currie38  
 SDB Cognitive and school performance impairments: Pediatric SDB, such as obstructive sleep apnea, has substantial adverse effects on cognition and school performance, with daytime behavioral comorbidities being the most significant (daytime sleepiness, hyperactivity, restlessness). Preschool children at risk for SDB who snored “frequently” or “almost always” had lower executive functioning. Karpinski et al87  
 Sleep duration Lower development scores in multiple domains: Chinese preschool children (N = 553; mean age 5.46 y), parent-reported daily sleep over a wk, only 11% with recommended 11–12 h per night. Those with sleep deprivation (<7 h per night) had lower total scores on the Chinese Early Development Instrument total scores in emotional maturity, language and/or cognitive and prosocial behaviors and higher scores in hyperactivity and/or inattention. Children were not screened for snoring or SBD risk factors. Sleep deprivation was more likely in low-SES homes, with lower maternal education,a and in children who used devices >3 h per d. Tso et al88  
 Lower SR: Israeli children who were unqualified (not school ready) for first grade compared with control children had shorter sleep durations, reduced sleep efficiency, increased nighttime awakenings, and more disordered sleep, insomnia, and hypersomnia. Ravid et al89  
 Dental caries Cognitive impairment and behavior problems: Chronic pain from caries impacts behavior, attention, learning, and school attendance. Caries that go untreated impact language development due to issues eating and speaking and/or learning. Children are more likely to have untreated caries if they are Hispanic or black. Currie38; CDC88  
 Malnutrition Increased risk of lead poisoning: Children with malnutrition are more likely to have anemia and absorb more lead, which puts them at higher risk for lead poisoning. Malnutrition is more common in children who are poor because of food insecurity and a lack of access to micronutrients. Currie38  
Special conditions   
 SCA Lower SR scores: Small case-control study of 4–6 y olds; those with SCA had lower scores in multiple domains on the Pediatric Examination of Educational Readiness and normal intelligence on McCarthy Scales of Children’s Abilities. Chua-Lim et al90  
 Language development: Small study; kindergarten children with SCA scored lower than matched controls on the Developing Skills Checklist in auditory discrimination and language. Steen et al91  
 Cerebral palsy Communication and social-emotional development: preschool-aged children (4–5 y) with cerebral palsy performed significantly below their peers in 3 of 5 key readiness-to-learn skill areas, including mobility, self-care, social function, and communication abilities on the Pediatric Evaluation of Disability Inventory. Gehrmann et al92  
 Pediatric Evaluation of Disability Inventory and communication using the Communication and Symbolic Behavior Scales Developmental Profile: Fifty-five percent of children demonstrated significantly delayed communication skills. These children qualify for EI in the United States, but no similar services exist in Australia for those <6 y of age. — 
Environmental exposures and hazards   
 Poor housing Poor housing and poor air quality are associated with higher rates of asthma.a Currie38  
 Lead poisoning Cognitive and behavioral impairments: Lead exposure is associated with lower IQ and more ADHD; black children are impacted more than white children. Poor areas have a higher incidence of lead exposure (historically through paint, gasoline, water, canned food; today through old pipes, residual in soil, and paint in old homes).a Currie38  
 IDA No impact on development: The incidence of IDA has decreased over time even in children who are disadvantaged because of iron-fortified formula and cereals and supplemental nutrition obtained through the WIC program. Little evidence exists to suggest IDA impacts cognitive development or SR. Currie38  
Maternal factors   
 Maternal depression Cognitive and social-emotional development: Maternal depression changes parent discipline (more physical force, less positive interactions) and worsens child outcomes, including more behavior problems, insecure attachment, cognitive problems, and reduced test scores by 0.33 SDs. Higher rates of prenatal depression and postpartum depression are seen in mothers who are poor.a Currie38  
 Breast feeding Promotes cognitive development: White women are more likely than black women to breastfeed (70% vs 40%, respectively). Breastfeeding supports cognitive development through disease prevention (less asthma, fewer ear infections); high long-chain fatty acid content supports brain development and increases infant-mother bonding and child’s IQ. Currie38  

ADHD, attention-deficit/hyperactivity disorder; AOM, acute otitis media; ECLS-B, Early Childhood Longitudinal Program Birth Cohort; EI, early intervention; IDA, iron deficiency anemia; ICU, intensive care unit; IUDE, in utero drug exposure; LPT, late-preterm infant; OME, otitis media with effusion; RDS, respiratory distress syndrome; SBD, sleep-disordered breathing; SCA, sickle cell anemia; SES, socioeconomic status; VLBW, very low birth weight; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children; —, not applicable.

a

Outcome is associated with poverty or low SES.

Prematurity and Early Life Exposures Impact Early Child Development

Children who are born prematurely or with prenatal and early life insults, including neonatal encephalopathy, cerebral palsy, and intrauterine drug exposure, are more likely to experience impairment in cognition, attention, and difficulty with learning later in life.38,72,81,92,94 Although specific developmental impairment varies by gestational age and neonatal conditions (Table 3), the most striking finding across conditions is that preterm and term children living in poverty are less likely to be ready for kindergarten, have less access to preschool, and receive less elementary school support than more advantaged peers who are born prematurely.75 Despite factors such as respiratory distress syndrome, chronic lung disease, or intraventricular hemorrhage, the most important factor when determining if late-preterm, premature, low birth weight or very low birth weight infants are ready for school is if they live in poverty.74,93,95 The evidence strongly suggests that intensive care coordination of developmental services, universal access to preschool, future school support, and antipoverty efforts can significantly close the SR gap in premature infants of low socioeconomic status,38,73,75,93 and researchers articulate these as an arena of potential collaboration between the ECE and pediatric communities.

Chronic Illness Impacts Early Child Development

Children with chronic illnesses are at risk for poor social-emotional and cognitive development96; conversely, our search revealed limited evidence that acute illness impacts early child development for SR. Many common chronic illnesses, such as obstructive sleep apnea, dental caries, allergies, asthma, sickle cell anemia, attention-deficit/hyperactivity disorder, malnutrition, and obesity, can impact a child’s early development across multiple SR domains (eg, social-emotional, cognitive, and language), leading to decreased early SR and long-term implications for academic achievement (Table 3).38,84,91,97 In particular, chronic otitis media and chronic respiratory disease put children at higher odds of being developmentally vulnerable across multiple developmental domains at school entry.82,85 Urban preschool children with “asthma that limits daily activity” have lower SR scores, and parents are more likely to report that their children need help in school.85 Pediatricians who care for children with chronic illness are responsible for more than their physical development because these conditions appear to impact multiple domains of development that are crucial to SR.

During our review of the child health literature, an important theme emerged: child poverty is independent and additive because it consistently undermines early child development. Children living in poverty face “double jeopardy” because poverty is a risk factor for poor SR,2 and being poor increases the likelihood of chronic health problems.20,38 Chronic illnesses, such as lead poisoning, asthma, dental caries, and malnutrition, continue to disproportionately impact poor children despite improved access to health care.20,38,98 The interactions between poverty, chronic illness, and child development require further transdisciplinary research.

Early Childhood Experiences

Early childhood experiences differ across income groups. For example, for children aged 0 to 2 years, those who are not poor are more likely than children who are poor to experience warm parenting practices (hugging) than punitive parenting practices (spanking).99 Children who are not poor from birth to 2 years old also have greater access to children’s books and are more likely to be read to than their poor counterparts.99,101 In their well-known study, Hart and Risley102 found that young children of parents who receive public assistance heard fewer than one-third as many words per hour as higher-income children, and the words were more likely to be negative.18,100,102,107 

Similarly, substantial differences exist in spending on child care, preschool participation, and access to educational resources, such as a home computer.108 It is important to note that lower-income families value SR18,109,110 but face innumerable financial, informational, and cultural barriers that limit access to high-quality child care, education,111 and preschool.112 For example, in 2010, ∼80% of 4-year-olds from families in the top one-fifth of the income distribution attended preschool compared with ∼60% of those in in the bottom one-fifth.69 These early childhood differences have significant consequences because children who experience responsive and stimulating care tend to score higher on assessments of physical, social-emotional, and cognitive development (literacy and numeracy) than those who do not.99,113,114 

Lessons Learned From Education to Improve Early Childhood Development

Gaps in early childhood development and SR stem from multiple sources. Researchers in both education and pediatric literature report positive relationships between child development and a range of early childhood experiences, such as breastfeeding,115 rich language environments,116 access to educational resources such as books,117 and book reading.118,119 There is extensive evidence that the quality of verbal interactions between parents and children during play, reading, and daily routines improves child development for SR.100,102,104,107,120,121 Maternal depression, stress,122,124 and harsh parenting125 are associated with negative child outcomes. Although parenting programs have had mixed results,126 some interventions (including nurse home-visitation programs,11,14,15 family literacy courses offered by child care centers and elementary schools,127,128 and text-messaging programs129) have improved parenting practices and led to improved child outcomes.

ECE programs affect child development: preschool experiences have positive effects on children’s cognitive development.130,131 In contrast, informal care (provided by family and friends) tends to be lower in quality and lead to lower SR.132 The most famous preschool intervention study, the HighScope Perry Preschool study,133 had positive effects even well into adulthood. Researchers in a meta-analysis of studies between 1967 and 2007 estimate a treatment effect for preschools on achievement outcomes of approximately one-third of an SD.134 Preschool effects appear to be particularly strong for children from underserved backgrounds.135 

Developmental surveillance and screening is an important part of routine pediatric care, and although related, it is distinct from SR screening in schools and clinics.2,35 The American Academy of Pediatrics and Bright Futures outline universal developmental surveillance for each well-child check in language and gross and fine motor domains with supplemental screening tools at certain ages (9 months, 18 months, and 2.5 years) to identify delays.2 Tools commonly used for general development include the Ages and Stages Questionnaires, the Parents’ Evaluation of Developmental Status, and The Survey of Well-being of Young Children; tools used for autism spectrum disorder include the Modified Checklist for Autism in Toddlers, Revised, with Follow-up (known as M-CHAT-R/F); and for psychosocial screening, the Survey of Well-being of Young Children, the Parents’ Evaluation of Developmental Status, and the Ages and Stages Questionnaires are used from 0 to 5 years of age.2 The goal in early delay identification is to connect children and families with community-based services, such as early intervention programs, home visitation programs, HS, and school-based special education programs, as soon as possible to maximize each child’s learning potential.2,35,136 Using a single developmental screener for diagnosis, special education placement, or delaying school entry runs the risk of misclassification. Using multiple screeners reduces this risk.136,137 

Although it is clear that children enter kindergarten with a range of SR skills, many school systems do not track incoming skills or skill development. Questions remain about how schools should assess students at kindergarten entry138 and how these Kindergarten Entry Assessments (KEAs) can be used to inform school, clinic, and community initiatives to improve SR gaps. States and school districts employ a wide range of KEAs, from parent intake forms to informal teacher observations or checklists and formative assessments.139 In 2014, >29 states were engaged in the development and implementation of various KEAs through federal grant programs, such as Race to the Top–Early Learning Challenge. The decentralized data present challenges because they do not allow for comparison across localities nor evaluation of programs or practices. Moreover, they are rarely available for community partners, such as the pediatric system, because of privacy restrictions.140 Although the evaluation of KEAs are underway to determine the long-term benefits for students, teachers, school districts, and states, there is no overarching effort to share data across the fields.

Like school system KEAs, efforts to assess SR in pediatric clinics have been underway for decades,141,145 yet no single SR screener has emerged as a comprehensive, validated, culturally sensitive tool. Common tools range from simple methods (the “Draw-a-Person” test146) to more complex screeners, such as the Kaufman Assessment Battery for Children test, McCarthy Scales of Children’s Abilities, Preschool Readiness Experimental Screening Scale, and the Bracken School Readiness Assessment.141,147,149 Many are heavily focused on cognitive and motor skills (eg, counting, and drawing a circle) rather than social emotional skills, which are equal if not better predictors of a child’s kindergarten success.2,150,152 Barriers to office screening include a lack of validated multidomain tools available in multiple languages; time for administration and scoring; a structured clinic system to provide parents with feedback and activate requisite referrals; and attendant reimbursement structures. Accurate SR assessment requires the integration of screening tools with parent perspectives, preschool teachers, and the child’s social situation to best capture the child’s strengths and areas in which to intervene.2,35,141 Although pediatricians are integral to this work, it requires a strong partnership with community-based early childhood systems. Recent national efforts, such as Help Me Grow, provide states with a model to leverage existing resources to ensure that communities identify vulnerable children, link families to community-based services, and empower families to support healthy child development.153,155 Overall, although both schools and clinics have a long history of using a wide range of assessments of children’s social emotional and cognitive development at kindergarten entry, a standard of practice and structural changes are needed in both settings.

The combination of high trust31,33,156,157 and near-universal access to 0- to 5-year-old children gives pediatricians an opportunity to address threats to optimal early childhood development (presented in Section 1), particularly in the most disenfranchised communities.103,104,158 On review of existing clinic-based SR interventions, we found interventions target the early educational gaps summarized in Section 1: parenting practices, verbal interaction, book sharing, and preschool access. In this section, we highlight the lessons learned from current interventions and provide an update on emerging models.

Review of existing evidence-based SR interventions (fully or partially clinic-based) targeted 3 distinct outcomes that are essential to SR (defined in Table 2): parent-child interactions, social-emotional development, and language development. Parent coaching improves parent-child interactions (Video Interaction Project [VIP], Building Blocks, and HealthySteps), behavioral parent training improves social-emotional development (the Triple P Positive Parenting Program, Incredible Years, and Help Me Grow), and early literacy promotion improves language development, daily reading, and access to books at home (Reach Out and Read [ROR], Little by Little School Readiness Program, Book Start, Let’s Read, City’s First Readers, and Bright Beginnings). Because in-depth descriptions of these programs exist elsewhere,159 we summarize the key component(s) below.

Although distinct in design, both the VIP and HealthySteps provide longitudinal, individualized 1:1 interactions between the parent(s) and a nonclinician provider to enrich parent-child interactions, such as reading, discipline, and daily parenting practices.158,160 After recurring, guided parent-child interactions in the clinic, VIP improved infant stimulation and parent reading,158 whereas HealthySteps improved positive parenting practices around discipline and sleep and increased access to services.160 The 1:1 interaction appears to be essential because Building Blocks, which mailed home developmental materials and toys, had less impact on infant stimulation and parenting stress than did VIP.158,161 Overall, in-person parent interactions with a nonclinician provider are an important feature for future interventions aimed at modifying parent-child interactions.

Recent meta-analyses reveal that 2 community-based behavioral parent training programs, the Positive Parenting Program and Incredible Years, improve child behaviors and parenting skills,162,163 which in turn improves social-emotional development. The Incredible Years Series uses group visits with video reflection, whereas the Positive Parenting Program stratifies group visit size on the basis of parent need (eg, serious problem behaviors requiring individualized sessions). When these programs occur within a pediatric clinic, it allows health providers to refer, communicate, and support serious behaviors or family needs.159 

The evidence-based clinic intervention with the most widespread dissemination to promote early literacy is ROR, in which pediatric clinicians provide books and model developmentally appropriate reading practices to low-income patients.164,166 Evidence strongly supports that ROR increases parent and child book sharing, supports reading as a favorite activity, increases daily reading, increases the number of books at home, and promotes language development across English, Spanish, and non–English-speaking low-income children.166,169 Since 2000, there have been multiple calls to incorporate ROR into all high-risk clinics.5,35,166 The key components of ROR have been successfully adapted in many settings: the Special Supplemental Nutrition Program for Women, Infants, and Children centers housing Little by Little; home visits with Book Start and 10 Books a Home; and community-wide campaigns to promote early literacy with City’s First Readers in New York City and Talk, Read, Sing across multiple communities (Oakland, CA, Tulsa, OK, Minneapolis, MN, and Miami, FL).159,170,172 

Several examples of child health systems in which families are directly linked to early education and education services exist. The first, a randomized trial in an urban pediatric clinic, improved HS enrollment via a computer-generated enrollment packet sent directly to HS (referral letter from a physician, physical examination, and immunization records) compared with providing parents with a list of HS phone numbers.173 This approach resulted in higher HS attendance, a higher likelihood of being on a waitlist, and increased direct contact of families by HS.174 This exemplifies how the clinic can bridge families and existing community resources. However, the reality of inadequate HS spots reduces this intervention’s impact. Second, library card distribution via clinic “prescriptions” are in the early stages of exploration.175 The strength here resides in parents’ reporting libraries as a frequented SR community resource,176,177 and library card ownership and use increase reading aloud by parents.178 A feasibility study revealed library card distribution by pediatric providers to be easy to incorporate into the workflow179; however, the link between card distribution and increasing library visits is not yet established. Third, a brief SR clinic appointment with a community health worker increased parent storytelling and library visits but needs further evaluation for generalizability.30,180 Last, low-cost evidence-based text-messaging programs129 empower preschool parents to promote SR, a “vaccine for SR,” so to speak. Once validated in a clinic setting, there is potential for widespread dissemination given the rapid and widespread adoption of text messaging from clinics to patients for other applications, such as appointment reminders.181 

The near-universal, repeated, and trusted access to even the most disconnected families provides the scaffolding for pediatrics to elevate its role in supporting the early childhood system by putting forward a comprehensive framework, such as an “SR Clinic” designation. This echoes previous efforts to create change within medicine, such as the Baby-Friendly designation, which >500 hospitals carry.182 This voluntary accreditation would convey a type of practice that is focused on early childhood learning. Such a designation could be earned by (1) providing a range of evidence-based 0-to-5 educational interventions in the clinic (ROR, HealthySteps, and VIP) and (2) achieving high, population-based SR rates.

A second opportunity lies in leveraging technological advances: options that are scalable and sustainable include automatic HealthySteps referrals, library card distribution, and text-messaging systems. The ubiquity of HS and libraries, in addition to the rapid adoption of electronic health records, makes such an effort not a technological challenge but one of priorities. SR is foundational for educational success, and significant gaps in SR exist for our low-income families, contributing to the cycle of poverty. Pediatricians are well positioned and thus should move quickly to adopt best practices to give all kids the best chance to succeed.

A third innovation opportunity takes advantage of novel data capacity generated by using KEAs, allowing for linkages between the health and education sectors. Data from KEAs and educational outcomes could be used to drive and inform clinic, school, and community SR efforts on a hyperlocal level as well as align ECE interventions in both fields with shared outcome metrics. Important privacy concerns are governed independently through the Family Educational Rights and Privacy Act in education and the Health Insurance Portability and Accountability Act in medicine, requiring data sharing between the health and education systems to be thoughtful; nevertheless, the interoperability of data is an area of promise and rapid growth.183 We suggest that these challenges are, again, not technologically insurmountable but require leadership and vision to overcome.

Finally, the promise in transdisciplinary work between the fields of education and pediatrics is fundamentally hindered by siloed funding. There are notable and visionary exceptions,184,186 but traditionally, extramural funding agencies and foundations solicit proposals from either the education or medicine field; thus, few opportunities exist to support innovative, transdisciplinary work. Ultimately, the sustainability challenge is health care financing, which cannot currently be used to reimburse providers for educational outcomes, although mechanisms to address this are being tried.187,188 

In this review, we attempt to bridge the education and pediatric literature to describe the challenges of addressing SR, catalog current evidence-based solutions, and highlight the value of integrative work compared with a health or education perspective alone. In challenges, we found that a lack of shared language across the fields drives inconsistency in how SR gaps are addressed in practice and in research. In solutions, we see that clinics are implementing SR interventions that complement, but do not replace, the known effects of high-quality preschool on a child’s overall development. Finally, we share new opportunities for collaboration to scale and increase the impact of SR interventions, such as an SR Clinic designation linked to school performance, but identify privacy restrictions, limited data sharing across fields, and restricted funding as implementation obstacles.

The evidence from both education and pediatrics is clear: low-income children start school farther behind than their advantaged peers. There is great opportunity for transdisciplinary work between those in education and pediatrics to drive the implementation of evidence-based solutions and ultimately improve the lives of young children.

     
  • ECE

    early childhood education

  •  
  • HS

    Head Start

  •  
  • KEA

    Kindergarten Entry Assessment

  •  
  • ROR

    Reach Out and Read

  •  
  • SR

    school readiness

  •  
  • VIP

    Video Interaction Project

Dr Peterson conceptualized the study, conducted the initial literature review, and wrote, critically reviewed, and revised the manuscript; Dr Loeb wrote the manuscript and critically reviewed and revised the manuscript; Dr Chamberlain conceptualized the study and wrote, critically reviewed, and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

FUNDING: Dr Chamberlain is supported as the Arline and Pete Harman Faculty Scholar by the Stanford University Child Health Research Institute.

We acknowledge the Stanford University librarians, Nicole Capdarest-Arest and Christopher Stave, for their incredible help with the literature review.

1
Johnson
SB
,
Riis
JL
,
Noble
KG
.
State of the Art Review: poverty and the developing brain.
Pediatrics
.
2016
;
137
(
4
):
e20153075
[PubMed]
2
Hagan
JF
,
Shaw
JS
,
Duncan
PM
, eds.
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
. 4th ed.
Elk Grove Village, IL
:
American Academy of Pediatrics
;
2017
3
Shonkoff
JP
.
From neurons to neighborhoods: old and new challenges for developmental and behavioral pediatrics.
J Dev Behav Pediatr
.
2003
;
24
(
1
):
70
76
[PubMed]
4
Garcia
E
,
Weiss
E
.
Education Inequalities at the School Starting Gate: Gaps, Trends, and Strategies to Address Them
.
Washington, DC
:
Economic Policy Institute
;
2017
5
Council on Community Pediatrics
.
Poverty and child health in the United States.
Pediatrics
.
2016
;
137
(
4
):
e20160339
6
Shonkoff
JP
,
Garner
AS
;
Committee on Psychosocial Aspects of Child and Family Health
;
Committee on Early Childhood, Adoption, and Dependent Care
;
Section on Developmental and Behavioral Pediatrics
.
The lifelong effects of early childhood adversity and toxic stress.
Pediatrics
.
2012
;
129
(
1
). Available at: www.pediatrics.org/cgi/content/full/129/1/e232
[PubMed]
7
Heckman
JJ
.
Schools, skills, and synapses.
Econ Inq
.
2008
;
46
(
3
):
289
[PubMed]
8
Heckman
JJ
,
Moon
SH
,
Pinto
R
,
Savelyev
PA
,
Yavitz
A
.
The rate of return to the High/Scope Perry Preschool program.
J Public Econ
.
2010
;
94
(
1–2
):
114
128
[PubMed]
9
Magnuson
K
,
Duncan
GJ
.
Can early childhood interventions decrease inequality of economic opportunity?
RSF
.
2016
;
2
(
2
):
123
141
[PubMed]
10
US Department of Health and Human Services, Administration for Children and Families
.
Head Start Impact Study: Final Report
.
Washington, DC
:
US Department of Health and Human Services, Administration for Children and Families
;
2010
11
Olds
DL
,
Eckenrode
J
,
Henderson
CR
 Jr
, et al
.
Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial.
JAMA
.
1997
;
278
(
8
):
637
643
[PubMed]
12
Chock
LR
,
Hayes
DK
,
Tomiyasu
DW
.
Insights in public health: the Special Supplemental Nutrition Program for women, infants and children: strengthening families for 40 years.
Hawaii J Med Public Health
.
2014
;
73
(
9
):
295
300
[PubMed]
13
Dahl
GB
,
Lochner
L
.
The impact of family income on child achievement: evidence from the earned income tax credit.
Am Econ Rev
.
2012
;
102
(
5
):
1927
1956
14
Miller
TR
.
Projected outcomes of nurse-family partnership home visitation during 1996-2013, USA.
Prev Sci
.
2015
;
16
(
6
):
765
777
15
Thorland
W
.
Nurse-Family Partnership: Research Outcomes
.
Denver, CO
:
Nurse-Family Partnership
;
2017
16
Duncan
GJ
,
Dowsett
CJ
,
Claessens
A
, et al
.
School readiness and later achievement.
Dev Psychol
.
2007
;
43
(
6
):
1428
1446
[PubMed]
17
Campbell
F
,
Conti
G
,
Heckman
JJ
, et al
.
Early childhood investments substantially boost adult health.
Science
.
2014
;
343
(
6178
):
1478
1485
[PubMed]
18
Karoly
LA
,
Gonzalez
GC
.
Early care and education for children in immigrant families.
Future Child
.
2011
;
21
(
1
):
71
101
[PubMed]
19
Yoshikawa
H
.
Long-term effects of early childhood programs on social outcomes and delinquency.
Future Child
.
1995
;
5
(
3
):
51
75
[PubMed]
20
Fiscella
K
,
Kitzman
H
.
Disparities in academic achievement and health: the intersection of child education and health policy.
Pediatrics
.
2009
;
123
(
3
):
1073
1080
[PubMed]
21
Rouse
C
,
Brooks-Gunn
J
,
McLanahan
S
.
Introducing the issue.
Future Child
.
2005
;
15
(
1
):
5
14
22
Baumgartner
EM
.
Making gains or falling behind? Changes and stability in school readiness.
Soc Sci Res
.
2017
;
64
:
277
298
[PubMed]
23
Bassok
D
,
Finch
JE
,
Lee
R
,
Reardon
SF
,
Waldfogel
J
.
Socioeconomic gaps in early childhood experiences: 1998 to 2010.
AERA Open
.
2016
;
2
(
3
):
1
22
24
Reardon
SF
,
Portilla
XA
.
Recent trends in income, racial, and ethnic school readiness gaps at kindergarten entry.
AERA Open
.
2016
;
2
(
3
):
1
18
25
Lopez
EM
,
Gallimore
R
,
Garnier
H
,
Reese
L
.
Preschool antecedents of mathematics achievement of Latinos: the influence of family resources, early literacy experiences, and preschool attendance.
Hisp J Behav Sci
.
2007
;
29
(
4
):
456
471
26
US Department of Education
. A matter of equity: Preschool in America. Washington, DC: 2014. Available at https://www2.ed.gov/documents/early-learning/matter-equity-preschool-america.pdf. Accessed on March 23, 2018
27
Herzfeldt-Kamprath
R
,
Adamu
M
;
Center for American Progress
. Why we need a federal preschool investment in 6 charts. 2014. Available at: https://www.americanprogress.org/issues/early-childhood/news/2014/12/09/102737/why-we-need-a-federal-preschool-investment-in-6-charts/. Accessed April 19, 2017
28
Williams
PG
,
Okamoto
J
,
Lieser
D
, et al;
Council on Early Childhood
;
Council on School Health
.
The pediatrician’s role in optimizing school readiness.
Pediatrics
.
2016
;
138
(
3
):
e20162293
29
Duncan
GJ
,
Brooks-Gunn
J
,
Klebanov
PK
.
Economic deprivation and early childhood development.
Child Dev
.
1994
;
65
(
spec no 2
):
296
318
[PubMed]
30
Peterson
J
.
Comprehensive Developmental and School Readiness Screening: Impact Report 2016
.
San Mateo, CA
:
Fair Oaks Health Center, San Mateo Medical Center
;
2016
31
Center for Education and Human Services
.
School Readiness Assessment
.
Menlo Park, CA
:
SRI International
;
2012
32
Brown
CM
,
Girio-Herrera
EL
,
Sherman
SN
,
Kahn
RS
,
Copeland
KA
.
Low-income parents’ perceptions of pediatrician advice on early childhood education.
J Community Health
.
2013
;
38
(
1
):
195
204
[PubMed]
33
Steinberg
JR
,
Bruce
JS
,
Marin-Nevarez
P
,
Phan
K
,
Merrell
SB
,
Chamberlain
LJ
.
Early childhood learning and the pediatrician: a qualitative study among diverse, low-income caregivers.
J Dev Behav Pediatr
.
2018
;
39
(
5
):
376
386
34
American Academy of Pediatrics
. AAP Agenda for children strategic priority: Poverty and child health. Elk Grove Village, IL: AAP; 2014. Available at: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/poverty/Pages/About-Us.aspx. Accessed on March 3, 2018
35
High
PC
;
American Academy of Pediatrics Committee on Early Childhood, Adoption, and Dependent Care and Council on School Health
.
School readiness.
Pediatrics
.
2008
;
121
(
4
). Available at: www.pediatrics.org/cgi/content/full/121/4/e1008
[PubMed]
36
High
PC
,
Klass
P
;
Council on Early Childhood
.
Literacy promotion: an essential component of primary care pediatric practice.
Pediatrics
.
2014
;
134
(
2
):
404
409
[PubMed]
37
High
PC
,
LaGasse
L
,
Becker
S
,
Ahlgren
I
,
Gardner
A
.
Literacy promotion in primary care pediatrics: can we make a difference?
Pediatrics
.
2000
;
105
(
4, pt 2
):
927
934
[PubMed]
38
Currie
J
.
Health disparities and gaps in school readiness.
Future Child
.
2005
;
15
(
1
):
117
138
[PubMed]
39
Hemphill
FC
,
Vanneman
A
.
Achievement Gaps: How Hispanic and White Students in Public Schools Perform in Mathematics and Reading on the National Assessment of Educational Progress. Statistical Analysis Report. NCES 2011-459
.
Washington, DC
:
National Center for Education Statistics
;
2011
40
Reardon
SF
.
The widening academic achievement gap between the rich and the poor: New evidence and possible explanations
. In:
Duncan
G
, ed.
Murnane
R
.
Whither Opportunity
.
New York, Chicago
:
Russell Sage Foundation, Spencer Foundation
;
2011
:
91
116
41
Reardon
SF
,
Robinson
JP
,
Weathers
E
. Patterns and trends in racial/ethnic and socioeconomic academic achievement gaps. In:
Ladd
HF
,
Goertz
ME
, eds.
Handbook of Research in Education Finance and Policy
.
New York, NY
:
Routledge
;
2015
:
491
509
42
Vanneman
A
,
Hamilton
L
,
Anderson
JB
,
Rahman
T
.
Achievement Gaps: How Black and White Students in Public Schools Perform in Mathematics and Reading on the National Assessment of Educational Progress. Statistical Analysis Report. NCES 2009-455
.
Washington, DC
:
National Center for Education Statistics
;
2009
43
Tourangeau
K
,
Nord
C
,
T
, et al
.
Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K: 2011). User’s Manual for the ECLS-K: 2011 Kindergarten Data File and Electronic Codebook, Public Version. NCES 2015-074
.
Washington, DC
:
National Center for Education Statistics
;
2015
44
Tourangeau
K
,
Nord
C
,
T
,
Sorongon
AG
,
Najarian
M
.
Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K): Combined User’s Manual for the ECLS-K Eighth-Grade and K-8 Full Sample Data Files and Electronic Codebooks. NCES 2009-004
.
Washington, DC
:
National Center for Education Statistics
;
2009
45
National Center for Education Statistics
.
The Nation’s Report Card: Mathematics 2011(NCES 2012–458)
.
Washington, DC
:
Institute of Education Sciences, U.S. Department of Education
;
2011
46
National Center for Education Statistics
.
The Nation’s Report Card: Mathematics and Reading 2011(NCES 2012–458)
.
Washington, DC
:
Institute of Education Sciences, U.S. Department of Education
;
2011
47
Fuller
B
,
Bridges
M
,
Bein
E
, et al
.
The health and cognitive growth of Latino toddlers: at risk or immigrant paradox?
Matern Child Health J
.
2009
;
13
(
6
):
755
768
[PubMed]
48
Fuller
B
,
García Coll
C
.
Learning from Latinos: contexts, families, and child development in motion.
Dev Psychol
.
2010
;
46
(
3
):
559
565
[PubMed]
49
Guerrero
AD
,
Fuller
B
,
Chu
L
, et al
.
Early growth of Mexican-American children: lagging in preliteracy skills but not social development.
Matern Child Health J
.
2013
;
17
(
9
):
1701
1711
[PubMed]
50
Administration for Children and Families
.
The Head Start Early Learning Outcomes Framework: Ages Birth to Five (HSELOF)
.
Washington, DC
:
Department of Health and Human Services
;
2015
51
US Department of Education
. Definitions. Available at: https://www.ed.gov/early-learning/elc-draft-summary/definitions. Accessed June 25, 2018
52
Carlton
MP
,
Winsler
A
.
School readiness: the need for a paradigm shift.
School Psych Rev
.
1999
;
28
(
3
):
338
352
53
Noble
KG
,
Tottenham
N
,
Casey
BJ
.
Neuroscience perspectives on disparities in school readiness and cognitive achievement.
Future Child
.
2005
;
15
(
1
):
71
89
[PubMed]
54
Ray
K
,
Smith
MC
.
The kindergarten child: what teachers and administrators need to know to promote academic success in all children.
Early Child Educ J
.
2010
;
38
(
1
):
5
18
55
Linder
SM
,
Ramey
MD
,
Zambak
S
.
Predictors of school readiness in literacy and mathematics: a selective review of the literature.
Early Child Res Pract
.
2013
;
15
(
1
):
1
9
56
Barnett
SE
.
The State of Preschool: 2004 State Preschool Yearbook.
2004
. Available at: http://nieer.org/state-preschool-yearbooks/state-preschool-2004. Accessed September 20, 2018
57
UNICEF
.
School Readiness: A Conceptual Framework
.
New York, NY
:
United Nations Children’s Fund
;
2012
58
Fryer
RG
.
The Black-White test score gap through third grade.
Am Law Econ Rev
.
2006
;
8
(
2
):
249
281
59
Lee
VE
,
Burkham
D
.
Inequality at the Starting Gate: Social Background Differences in Achievement as Children Begin Kindergarten
.
Washington, DC
:
Economic Policy Institute
;
2002
60
Bassok
D
,
Latham
S
. Kids today: Changes in school readiness in an early childhood era. Charlottesville, VA: University of Virginia, EdPolicyWorks; 2016. Available at: https://curry.virginia.edu/search-results?search=kids+today+2016+. Accessed September 20, 2018
61
Chen
C
,
Lee
SY
,
Stevenson
HW
.
Long-term prediction of academic achievement of American, Chinese, and Japanese adolescents.
J Educ Psychol
.
1996
;
88
(
4
):
750
759
62
Luster
T
,
McAdoo
H
.
Family and child influences on educational attainment: a secondary analysis of the high/scope Perry Preschool data.
Dev Psychol
.
1996
;
32
(
1
):
26
39
63
Phillips
M
,
Crouse
J
,
Ralph
J
. Does the Black-White test score gap widen after children enter school. In:
Jencks
C
,
Phillips
M
, eds.
The Black-White Test Score Gap
.
Washington, DC
:
Brookings Institution Press
;
1998
:
229
272
64
Bassok
D
,
Finch
JE
,
Lee
R
,
Reardon
SF
,
Waldfogel
J
.
Socioeconomic gaps in early childhood experiences: 1998 to 2010.
AERA Open
.
2016
;
2
(
3
):
1
22
65
Barnett
WS
,
Carolan
ME
,
Squires
JH
,
Brown
KC
.
The State of Preschool 2013: First Look. NCES 2014-078
.
Jessup, MD
:
National Center for Education Statistics
;
2014
66
Davis
J
,
Bauman
K.
School enrollment in the United States: 2011. Washington DC: US Census Bureau; 2013. Available at: https://www.census.gov/library/publications/2013/demo/p20-571.html. Accessed September 21, 2018
67
National Institute for Early Education Research
. State preschool yearbook. 2013. Available at: http://nieer.org/state-preschool-yearbooks/the-state-of-preschool-2013. Accessed April 21, 2017
68
National Center for Education Statistics
.
Preschool and Kindergarten Enrollment 2000 - 2015
.
Washington, DC
:
US Department of Education
;
2017
69
Magnuson
K
,
Waldfogel
J
.
Trends in income-related gaps in enrollment in early childhood education: 1968 to 2013.
AERA Open
.
2016
;
2
(
2
)
[PubMed]
70
Kena
G
,
Hussar
W
,
McFarland
J
, et al
.
The Condition of Education 2016. NCES 2016-144
.
Washington, DC
:
National Center for Education Statistics
;
2016
71
Schneider
B
,
Martinez
S
,
Owens
A
. Barriers to educational opportunities for Hispanics in the United States. In:
Tienda
M
,
Michell
F
, eds.
Hispanics and the Future of America
.
Washington, DC
:
National Academies Press
;
2006
:
179
227
72
Reichman
NE
.
Low birth weight and school readiness.
Future Child
.
2005
;
15
(
1
):
91
116
[PubMed]
73
Bauer
SC
,
Msall
ME
.
Kindergarten readiness after prematurity: integrating health, development, and behavioral functioning to optimize educational outcomes of vulnerable children.
Dev Disabil Res Rev
.
2010
;
16
(
4
):
313
322
[PubMed]
74
Patrianakos-Hoobler
AI
,
Msall
ME
,
Marks
JD
,
Huo
D
,
Schreiber
MD
.
Risk factors affecting school readiness in premature infants with respiratory distress syndrome.
Pediatrics
.
2009
;
124
(
1
):
258
267
[PubMed]
75
Patrianakos-Hoobler
AI
,
Msall
ME
,
Huo
D
,
Marks
JD
,
Plesha-Troyke
S
,
Schreiber
MD
.
Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm.
Dev Med Child Neurol
.
2010
;
52
(
4
):
379
385
[PubMed]
76
Bauer
SC
,
Msall
ME
.
Optimizing neurodevelopmental outcomes after prematurity: lessons in neuroprotection and early intervention.
Minerva Pediatr
.
2010
;
62
(
5
):
485
497
[PubMed]
77
Shah
PE
,
Kaciroti
N
,
Richards
B
,
Lumeng
JC
.
Gestational age and kindergarten school readiness in a national sample of preterm infants.
J Pediatr
.
2016
;
178
:
61
67
[PubMed]
78
Woythaler
M
,
McCormick
MC
,
Mao
WY
,
Smith
VC
.
Late preterm infants and neurodevelopmental outcomes at kindergarten.
Pediatrics
.
2015
;
136
(
3
):
424
431
[PubMed]
79
Robertson
CM
,
Finer
NN
.
Educational readiness of survivors of neonatal encephalopathy associated with birth asphyxia at term.
J Dev Behav Pediatr
.
1988
;
9
(
5
):
298
306
[PubMed]
80
Butz
AM
,
Pulsifer
MB
,
Leppert
M
,
Rimrodt
S
,
Belcher
H
.
Comparison of intelligence, school readiness skills, and attention in in-utero drug-exposed and nonexposed preschool children.
Clin Pediatr (Phila)
.
2003
;
42
(
8
):
727
739
[PubMed]
81
Jain
G
,
Mahendra
V
,
Singhal
S
, et al
.
Long-term neuropsychological effects of opioid use in children: a descriptive literature review.
Pain Physician
.
2014
;
17
(
2
):
109
118
[PubMed]
82
Eiserman
WD
,
Shisler
L
,
Foust
T
,
Buhrmann
J
,
Winston
R
,
White
K
.
Updating hearing screening practices in early childhood settings.
Infants Young Child
.
2008
;
21
(
3
):
186
193
83
Roberts
JE
,
Burchinal
MR
,
Jackson
SC
, et al
.
Otitis media in childhood in relation to preschool language and school readiness skills among black children.
Pediatrics
.
2000
;
106
(
4
):
725
735
[PubMed]
84
Bell
MF
,
Bayliss
DM
,
Glauert
R
,
Harrison
A
,
Ohan
JL
.
Chronic illness and developmental vulnerability at school entry.
Pediatrics
.
2016
;
137
(
5
):
e20152475
[PubMed]
85
Halterman
JS
,
Montes
G
,
Aligne
CA
,
Kaczorowski
JM
,
Hightower
AD
,
Szilagyi
PG
.
School readiness among urban children with asthma.
Ambul Pediatr
.
2001
;
1
(
4
):
201
205
[PubMed]
86
Thomaidis
L
,
Choleva
A
,
Janikian
M
, et al
.
Attention Deficit/Hyperactivity Disorder (ADHD) symptoms and cognitive skills of preschool children.
Psychiatriki
.
2017
;
28
(
1
):
28
36
87
Karpinski
AC
,
Scullin
MH
,
Montgomery-Downs
HE
.
Risk for sleep-disordered breathing and executive function in preschoolers.
Sleep Med
.
2008
;
9
(
4
):
418
424
[PubMed]
88
Tso
W
,
Rao
N
,
Jiang
F
, et al
.
Sleep duration and school readiness of Chinese preschool children.
J Pediatr
.
2016
;
169
:
266
271
[PubMed]
89
Ravid
S
,
Afek
I
,
Suraiya
S
,
Shahar
E
,
Pillar
G
.
Kindergarten children’s failure to qualify for first grade could result from sleep disturbances.
J Child Neurol
.
2009
;
24
(
7
):
816
822
[PubMed]
90
Chua-Lim
C
,
Moore
RB
,
McCleary
G
,
Shah
A
,
Mankad
VN
.
Deficiencies in school readiness skills of children with sickle cell anemia: a preliminary report.
South Med J
.
1993
;
86
(
4
):
397
402
[PubMed]
91
Steen
RG
,
Hu
XJ
,
Elliott
VE
,
Miles
MA
,
Jones
S
,
Wang
WC
.
Kindergarten readiness skills in children with sickle cell disease: evidence of early neurocognitive damage?
J Child Neurol
.
2002
;
17
(
2
):
111
116
[PubMed]
92
Gehrmann
FE
,
Coleman
A
,
Weir
KA
,
Ware
RS
,
Boyd
RN
.
School readiness of children with cerebral palsy.
Dev Med Child Neurol
.
2014
;
56
(
8
):
786
793
[PubMed]
93
Dunn
HG
.
Social aspects of low birth weight.
Can Med Assoc J
.
1984
;
130
(
9
):
1131
1140
[PubMed]
94
Robertson
CM
,
Grace
MG
.
Validation of prediction of kindergarten-age school-readiness scores of nondisabled survivors of moderate neonatal encephalopathy in term infants.
Can J Public Health
.
1992
;
83
(
suppl 2
):
S51
S57
95
Bauer
NS
,
Anand
V
,
Carroll
AE
,
Downs
SM
.
Secondhand smoke exposure, parental depressive symptoms and preschool behavioral outcomes.
J Pediatr Nurs
.
2015
;
30
(
1
):
227
235
[PubMed]
96
Coller
RJ
,
Lerner
CF
,
Eickhoff
JC
, et al
.
Medical complexity among children with special health care needs: a two-dimensional view.
Health Serv Res
.
2016
;
51
(
4
):
1644
1669
[PubMed]
97
Miller
AL
,
Lumeng
CN
,
Delproposto
J
,
Florek
B
,
Wendorf
K
,
Lumeng
JC
.
Obesity-related hormones in low-income preschool-age children: implications for school readiness.
Mind Brain Educ
.
2013
;
7
(
4
):
246
255
[PubMed]
98
The Henry J. Kaiser Family Foundation
. Where are states today? Medicaid and CHIP eligibility levels for children, pregnant women, and adults. San Francisco: Kaiser Family Foundation; 2017. Available at: http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/. Accessed Septemner 21, 2018
99
Bradley
RH
,
Convyn
RF
,
Burchinal
M
,
McAdoo
HP
,
Coll
CG
.
The home environments of children in the United States part II: relations with behavioral development through age thirteen.
Child Dev
.
2001
;
72
(
6
):
1868
1886
[PubMed]
100
Gilkerson
J
,
Richards
JA
.
The LENA Natural Language Study
.
Boulder, CO
:
LENA Foundation
;
2008
101
Lareau
A
.
Unequal Childhoods: Class, Race, and Family Life
.
Berkeley, CA
:
University of California Press
;
2011
102
Hart
B
,
Risley
TR
.
Meaningful Differences in the Everyday Experience of Young American Children
.
Baltimore, MD
:
Paul H. Brookes Publishing
;
1995
103
Hart
B
,
Risley
TR
.
The early catastrophe: the 30 million word gap by age 3.
Am Educ
.
2003
;
27
(
1
):
4
9
104
Fernald
A
,
Marchman
VA
,
Weisleder
A
.
SES differences in language processing skill and vocabulary are evident at 18 months.
Dev Sci
.
2013
;
16
(
2
):
234
248
[PubMed]
105
Hirsh-Pasek
K
,
Adamson
LB
,
Bakeman
R
, et al
.
The contribution of early communication quality to low-income children’s language success.
Psychol Sci
.
2015
;
26
(
7
):
1071
1083
[PubMed]
106
Kuhn
LJ
,
Willoughby
MT
,
Wilbourn
MP
,
Vernon-Feagans
L
,
Blair
CB
;
Family Life Project Key Investigators
.
Early communicative gestures prospectively predict language development and executive function in early childhood.
Child Dev
.
2014
;
85
(
5
):
1898
1914
[PubMed]
107
Rowe
ML
,
Zuckerman
B
.
Word gap redux: developmental sequence and quality.
JAMA Pediatr
.
2016
;
170
(
9
):
827
828
[PubMed]
108
Kaushal
N
,
Magnuson
K
,
Waldfogel
J
. How is family income related to investments in children’s learning? In:
Duncan
G
,
Murnane
R
, eds.
Whither Opportunity? Rising Inequality, Schools, and Children’s Life Chances
.
New York, NY
:
Russell Sage Foundation
;
2011
:
187
205
109
Peterson
J
,
Bruce
J
,
Patel
N
,
Chamberlain
LJ
.
Parental attitudes, behaviors, and barriers to school readiness among parents of low-income Latino children.
Int J Environ Res Public Health
.
2018
;
15
(
2
):
E188
[PubMed]
110
Gazoli-Lee
E
.
Family Involvement to Promote Student Achievement - A Best Practices Literature Review
.
Saint Paul, MN
:
Wilder Research Center
;
1999
111
Gormley
WT
 Jr
,
Phillips
DA
,
Newmark
K
,
Welti
K
,
Adelstein
S
.
Social-emotional effects of early childhood education programs in Tulsa.
Child Dev
.
2011
;
82
(
6
):
2095
2109
[PubMed]
112
Magnuson
KA
,
Meyers
MK
,
Ruhm
CJ
,
Waldfogel
J
.
Inequality in preschool education and school readiness.
Am Educ Res J
.
2004
;
41
(
1
):
115
157
113
NICHD Early Child Care Research Network
.
Child-care effect sizes for the NICHD Study of Early Child Care and Youth Development.
Am Psychol
.
2006
;
61
(
2
):
99
116
[PubMed]
114
Melhuish
EC
,
Phan
MB
,
Sylva
K
,
Sammons
P
,
Siraj‐Blatchford
I
,
Taggart
B
.
Effects of the home learning environment and preschool center experience upon literacy and numeracy development in early primary school.
J Soc Issues
.
2008
;
64
(
1
):
95
114
115
Anderson
JW
,
Johnstone
BM
,
Remley
DT
.
Breast-feeding and cognitive development: a meta-analysis.
Am J Clin Nutr
.
1999
;
70
(
4
):
525
535
[PubMed]
116
Huttenlocher
J
,
Haight
W
,
Bryk
A
,
Seltzer
M
,
Lyons
T
.
Early vocabulary growth: relation to language input and gender.
Dev Psychol
.
1991
;
27
(
2
):
236
248
117
Linver
MR
,
Brooks-Gunn
J
,
Kohen
DE
.
Family processes as pathways from income to young children’s development.
Dev Psychol
.
2002
;
38
(
5
):
719
734
[PubMed]
118
Bus
AG
,
Van Ijzendoorn
MH
,
Pellegrini
AD
.
Joint book reading makes for success in learning to read: a meta-analysis on intergenerational transmission of literacy.
Rev Educ Res
.
1995
;
65
(
1
):
1
21
119
Debaryshe
BD
.
Joint picture-book reading correlates of early oral language skill.
J Child Lang
.
1993
;
20
(
2
):
455
461
[PubMed]
120
Landry
SH
,
Smith
KE
,
Swank
PR
.
The importance of parenting during early childhood for school-age development.
Dev Neuropsychol
.
2003
;
24
(
2–3
):
559
591
[PubMed]
121
Tamis-LeMonda
CS
,
Bornstein
MH
,
Baumwell
L
.
Maternal responsiveness and children’s achievement of language milestones.
Child Dev
.
2001
;
72
(
3
):
748
767
[PubMed]
122
Cummings
EM
,
Davies
PT
.
Maternal depression and child development.
J Child Psychol Psychiatry
.
1994
;
35
(
1
):
73
112
[PubMed]
123
Mistry
RS
,
Vandewater
EA
,
Huston
AC
,
McLoyd
VC
.
Economic well-being and children’s social adjustment: the role of family process in an ethnically diverse low-income sample.
Child Dev
.
2002
;
73
(
3
):
935
951
[PubMed]
124
Petterson
SM
,
Albers
AB
.
Effects of poverty and maternal depression on early child development.
Child Dev
.
2001
;
72
(
6
):
1794
1813
[PubMed]
125
McLoyd
VC
.
Socioeconomic disadvantage and child development.
Am Psychol
.
1998
;
53
(
2
):
185
204
[PubMed]
126
Duncan
GJ
,
Ludwig
J
,
Magnuson
KA
. Child development. In:
Levine
P
,
Zimmerman
D
, eds.
Targeting Investments in Children: Fighting Poverty When Resources Are Limited
.
Chicago, IL
:
University of Chicago Press
;
2010
:
27
58
127
Whitehurst
GJ
,
Arnold
DS
,
Epstein
JN
,
Angell
AL
,
Smith
M
,
Fischel
JE
.
A picture book reading intervention in day care and home for children from low-income families.
Dev Psychol
.
1994
;
30
(
5
):
679
689
128
Jordan
GE
,
Snow
CE
,
Porche
MV
.
Project EASE: the effect of a family literacy project on kindergarten students’ early literacy skills.
Read Res Q
.
2000
;
35
(
4
):
524
546
129
York
BN
,
Loeb
S
,
Doss
C
.
One step at a time: the effects of an early literacy text messaging program for parents of preschoolers [published online ahead of print January 4, 2018]
.
J Hum Resour
.
130
Currie
J
.
Early childhood education programs.
J Econ Perspect
.
2001
;
15
(
2
):
213
238
131
Campbell
FA
,
Ramey
CT
,
Pungello
E
,
Sparling
J
,
Miller-Johnson
S
.
Early childhood education: young adult outcomes from the Abecedarian Project.
Appl Dev Sci
.
2002
;
6
(
1
):
42
57
132
Bassok
D
,
Fitzpatrick
M
,
Greenberg
E
,
Loeb
S
.
Within- and between-sector quality differences in early childhood education and care.
Child Dev
.
2016
;
87
(
5
):
1627
1645
[PubMed]
133
Barnett
WS
.
Lives in the Balance: Age-27 Benefit-Cost Analysis of the High/Scope Perry Preschool Program (Monographs of the High/Scope Educational Research Foundation, Number Eleven)
.
Washington, DC
:
Education Resources Information Center
;
1996
134
Leak
J
,
Duncan
G
,
Li
W
,
Magnuson
K
,
Schindler
H
,
Yoshikawa
H
. Is timing everything? How early childhood education program cognitive and achievement impacts vary by starting age, program duration and time since the end of the program. In: Proceedings of the Biennial Meeting for the Society for Research on Child Development, Montreal, Quebec, Canada
135
Bassok
D
.
Do Black and Hispanic children benefit more from preschool? Understanding differences in preschool effects across racial groups.
Child Dev
.
2010
;
81
(
6
):
1828
1845
[PubMed]
136
Byrd
RS
.
School failure: assessment, intervention, and prevention in primary pediatric care.
Pediatr Rev
.
2005
;
26
(
7
):
233
243
[PubMed]
137
American Academy of Pediatrics Committee on School Health, Committee on Early Childhood, Adoption and Dependent Care
.
The inappropriate use of school “readiness” tests. American Academy of Pediatrics Committee on School Health and Committee on Early Childhood, Adoption and Dependent Care.
Pediatrics
.
1995
;
95
(
3
):
437
438
[PubMed]
138
Clemens
C
,
Doolittle
RP
,
Hoyle
M
.
Kindergarten health assessment reports: what do schools really learn from them?
Clin Pediatr (Phila)
.
2002
;
41
(
2
):
93
98
[PubMed]
139
US Department of Education, Office of Planning, Evaluation and Policy Development, Policy and Program Studies Service
.
Case Studies of the Early Implementation of Kindergarten Entry Assessments Final Report
.
Washington, DC
:
US Department of Education, Office of Planning, Evaluation and Policy Development, Policy and Program Studies Service
;
2016
140
US Department of Education
. Race to the top: early learning challenge. Available at: https://www2.ed.gov/programs/racetothetop-earlylearningchallenge/index.html. Accessed March 23, 2018
141
Dworkin
PH
.
The preschool child: developmental themes and clinical issues.
Curr Probl Pediatr
.
1988
;
18
(
2
):
73
134
[PubMed]
142
Sprigle
HA
,
Lanier
J
.
Validation and standardization of a school readiness screening test.
J Pediatr
.
1967
;
70
(
4
):
602
607
[PubMed]
143
Sturner
RA
,
Funk
SG
,
Green
JA
.
Predicting kindergarten school performance using the McCarthy Scales of Children’s Abilities.
J Pediatr Psychol
.
1984
;
9
(
4
):
495
503
[PubMed]
144
Ireton
H
,
Quast
W
,
Gantcher
P
.
The Draw-A-Man Test as an index of developmental disorders in a pediatric outpatient population.
Child Psychiatry Hum Dev
.
1971
;
2
(
1
):
42
49
[PubMed]
145
Pati
S
,
Hashim
K
,
Brown
B
,
Fiks
AG
,
Forrest
CB
.
Early identification of young children at risk for poor academic achievement: preliminary development of a parent-report prediction tool.
BMC Health Serv Res
.
2011
;
11
:
197
[PubMed]
146
Kahl
L
,
Hughes
HK
, eds.
The Harriet Lane Handbook E-Book
.
Amsterdam, Netherlands
:
Elsevier Health Sciences
;
2017
147
McCarthy
DA
.
McCarthy Scales of Children’s Abilities
.
New York, NY
:
Psychological Corporation
;
1972
148
Kaufman
AS
,
O’Neal
MR
,
Avant
AH
,
Long
SW
.
Introduction to the Kaufman Assessment Battery for Children (K-ABC) for pediatric neuroclinicians.
J Child Neurol
.
1987
;
2
(
1
):
3
16
[PubMed]
149
Panter
JE
,
Bracken
BA
.
Validity of the Bracken School Readiness Assessment for predicting first grade readiness.
Psychol Sch
.
2009
;
46
(
5
):
397
409
150
Helmsen
J
,
Petermann
F
,
Wiedebusch
S
.
Assessment of social-emotional competence in health examination for school entry [in German].
Gesundheitswesen
.
2009
;
71
(
10
):
669
674
[PubMed]
151
Burakevych
N
,
McKinlay
CJ
,
Alsweiler
JM
,
Wouldes
TA
,
Harding
JE
.
Pre-school screening for developmental and emotional health: comparison with neurodevelopmental assessment.
J Paediatr Child Health
.
2016
;
52
(
6
):
600
607
[PubMed]
152
Parker
S
,
Zuckerman
B
,
Augustyn
M
, eds.
Developmental and Behavioral Pediatrics
.
Philadelphia, PA
:
Lippincott Williams & Wilkins
;
2005
153
Help Me Grow National Center
. The HMG model. 2017. Available at: https://helpmegrownational.org/what-is-help-me-grow/hmg-system-model/. Accessed on July 27, 2017
154
McKay
K
,
Shannon
A
,
Vater
S
,
Dworkin
PH
.
ChildServ: lessons learned from the design and implementation of a community‐based developmental surveillance program.
Infants Young Child
.
2006
;
19
(
4
):
371
377
155
Dworkin
PH
.
Historical overview: from ChildServ to Help Me Grow.
J Dev Behav Pediatr
.
2006
;
27
(
suppl 1
):
S5
S7; discussion S17–S21, S50–S52
[PubMed]
156
Busey
SL
,
Kinyoun-Webb
C
,
Martin-McKay
J
,
Mao
J
.
Perceptions of inner city parents about early behavioral and violence prevention counseling.
Patient Educ Couns
.
2006
;
64
(
1–3
):
191
196
[PubMed]
157
Cheng
TL
,
Savageau
JA
,
DeWitt
TG
,
Bigelow
C
,
Charney
E
.
Expectations, goals, and perceived effectiveness of child health supervision: a study of mothers in a pediatric practice.
Clin Pediatr (Phila)
.
1996
;
35
(
3
):
129
137
[PubMed]
158
Mendelsohn
AL
,
Huberman
HS
,
Berkule
SB
,
Brockmeyer
CA
,
Morrow
LM
,
Dreyer
BP
.
Primary care strategies for promoting parent-child interactions and school readiness in at-risk families: the Bellevue Project for Early Language, Literacy, and Education Success.
Arch Pediatr Adolesc Med
.
2011
;
165
(
1
):
33
41
[PubMed]
159
Cates
CB
,
Weisleder
A
,
Mendelsohn
AL
.
Mitigating the effects of family poverty on early child development through parenting interventions in primary care.
Acad Pediatr
.
2016
;
16
(
suppl 3
):
S112
S120
[PubMed]
160
Zuckerman
B
,
Parker
S
,
Kaplan-Sanoff
M
,
Augustyn
M
,
Barth
MC
.
Healthy Steps: a case study of innovation in pediatric practice.
Pediatrics
.
2004
;
114
(
3
):
820
826
[PubMed]
161
Cates
CB
,
Weisleder
A
,
Dreyer
BP
, et al
.
Leveraging healthcare to promote responsive parenting: impacts of the video interaction project on parenting stress.
J Child Fam Stud
.
2016
;
25
(
3
):
827
835
[PubMed]
162
Menting
AT
,
Orobio de Castro
B
,
Matthys
W
.
Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: a meta-analytic review.
Clin Psychol Rev
.
2013
;
33
(
8
):
901
913
[PubMed]
163
Nowak
C
,
Heinrichs
N
.
A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: effectiveness and moderating variables.
Clin Child Fam Psychol Rev
.
2008
;
11
(
3
):
114
144
[PubMed]
164
Zuckerman
B
,
Augustyn
M
.
Books and reading: evidence-based standard of care whose time has come.
Acad Pediatr
.
2011
;
11
(
1
):
11
17
[PubMed]
165
Zuckerman
B
,
Khandekar
A
.
Reach Out and Read: evidence based approach to promoting early child development.
Curr Opin Pediatr
.
2010
;
22
(
4
):
539
544
[PubMed]
166
Hagan
JF
,
Shaw
JS
,
Duncan
PM
, eds.
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
. 3rd ed.
Elk Grove Village, IL
:
American Academy of Pediatrics
;
2008
167
Silverstein
M
,
Iverson
L
,
Lozano
P
.
An English-language clinic-based literacy program is effective for a multilingual population.
Pediatrics
.
2002
;
109
(
5
). Available at: www.pediatrics.org/cgi/content/full/109/5/e76
[PubMed]
168
Golova
N
,
Alario
AJ
,
Vivier
PM
,
Rodriguez
M
,
High
PC
.
Literacy promotion for Hispanic families in a primary care setting: a randomized, controlled trial.
Pediatrics
.
1999
;
103
(
5 pt 1
):
993
997
[PubMed]
169
Needlman
R
,
Toker
KH
,
Dreyer
BP
,
Klass
P
,
Mendelsohn
AL
.
Effectiveness of a primary care intervention to support reading aloud: a multicenter evaluation.
Ambul Pediatr
.
2005
;
5
(
4
):
209
215
170
Whaley
SE
,
Jiang
L
,
Gomez
J
,
Jenks
E
.
Literacy promotion for families participating in the women, infants and children program.
Pediatrics
.
2011
;
127
(
3
):
454
461
[PubMed]
171
Ten Books a Home
.
Ten books a home: 2015–2016 report card
.
2016
;
1
5
. Available at: http://www.10booksahome.org/impact.html. Accessed September 21, 2018
172
Too Small to Fail Foundation
.
Talk, read, sing community campaign guide
.
2017
;
1
34
. Available at http://talkingisteaching.org/community-login. Accessed September 21, 2018
173
Silverstein
M
,
Mack
C
,
Reavis
N
,
Koepsell
TD
,
Gross
GS
,
Grossman
DC
.
Effect of a clinic-based referral system to head start: a randomized controlled trial.
JAMA
.
2004
;
292
(
8
):
968
971
[PubMed]
174
Silverstein
M
,
Augustyn
M
,
Cabral
H
,
Zuckerman
B
.
Maternal depression and violence exposure: double jeopardy for child school functioning.
Pediatrics
.
2006
;
118
(
3
). Available at: www.pediatrics.org/cgi/content/full/118/3/e792
[PubMed]
175
Kumar
MM
,
Cowan
HR
,
Erdman
L
,
Kaufman
M
,
Hick
KM
.
Reach out and read is feasible and effective for adolescent mothers: a pilot study.
Matern Child Health J
.
2016
;
20
(
3
):
630
638
176
Vélez
LF
,
Sanitato
M
,
Barry
D
, et al
.
The role of health systems and policy in producing behavior and social change to enhance child survival and development in low- and middle-income countries: an examination of the evidence.
J Health Commun
.
2014
;
19
(
suppl 1
):
89
121
[PubMed]
177
Birckmayer
J
.
The role of public libraries in emergent and family literacy.
Zero Three
.
2001
;
21
(
3
):
25
29
178
Chen
P
,
Rea
C
,
Shaw
R
,
Bottino
CJ
.
Associations between public library use and reading aloud among families with young children.
J Pediatr
.
2016
;
173
:
221
227.e1
[PubMed]
179
Gollapudi
A
,
Bruce
JCR
.
Library card distribution at a Federally Qualified Health Center to increase public library usage
. In: Proceedings of the 8th Annual Pediatrics Research Retreat; April 7;
2017
; Stanford, CA
180
Peterson
J
,
Huffman
LC
,
Bruce
J
,
Chamberlain
LJ
.
A clinic based SR intervention for low-income Latino children: an intervention cohort study
. In: Proceedings of the ;
May 5, 2018
;
Toronto, Canada
181
Car
J
,
Gurol-Urganci
I
,
de Jongh
T
,
Vodopivec-Jamsek
V
,
Atun
R
.
Mobile phone messaging reminders for attendance at healthcare appointments.
Cochrane Database Syst Rev
.
2012
;(
7
):
CD007458
[PubMed]
182
Baby-Friendly USA
. Baby-friendly designated facilities. 2018. Available at: https://www.babyfriendlyusa.org/find-facilities. Accessed March 22, 2018
183
AcademyHealth
. The national interoperability collaborative. Washington, DC: 2018. Available at: www.academyhealth.org/about/programs/national-interoperability-collaborative. Accessed April 3, 2018
184
Eunice Kennedy Shriver National Institute of Child Health and Development
. Grants and funding. Available at: https://www.nichd.nih.gov/grants-contracts/FOAs-notices. Accessed July 19, 2018
185
David and Lucile Packard Foundation
. What we fund. Available at: https://www.packard.org/what-we-fund/. Accessed July 19, 2018
186
Heising-Simons Foundation
. Available at: https://www.hsfoundation.org/. Accessed July 19, 2018
187
Gustafsson-Wright
E
,
Golden
M
,
Aigner-Treworgy
S
.
Identifying Education Outcomes for Social Impact Bonds for Early Childhood
.
Washington, DC
:
Brookings
;
2015
188
Homer
C
,
Gillooly
M
,
Vinci
R
,
Bair-Merr
M
. School readiness: the next essential quality metric for children. Health Affairs Blog. Betheseda, MD: Health Affairs; 2018. Available at: https://www.healthaffairs.org/do/10.1377/hblog20180711.857544/full/. Accessed September 21, 2018

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.