Healthy and Ready to Learn: Prevalence and Correlates of School Readiness among United States Preschoolers

OBJECTIVE: To assess the national and state prevalence of being Healthy and Ready to Learn (HRL) and associated sociodemographic, health, family and neighborhood factors. METHODS: Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: Early Learning Skills, Social-Emotional Development, Self-Regulation, and Physical Well-being and Motor Development. Each item and domain were scored according to age-specific standards as On-Track, Needs Support, and At Risk with overall HRL defined as On-Track in all domains for 7565 randomly selected children ages 3 to 5 years. RESULTS: In 2016, 42.2% of children ages 3 to 5 years were considered HRL with the proportion considered On-Track ranging from 58.4% for Early Learning Skills to 85.5% for Physical Well-being and Motor Development; approximately 80% of children were considered On-Track in Social-Emotional Development and Self-Regulation, respectively. Sociodemographic differences were mostly non-significant in multivariable analyses. Health, family, and neighborhood factors (ie, special health care needs status/type, parental mental health, reading, singing and storytelling, screen time, adverse childhood experiences, and neighborhood amenities) were associated with HRL. HRL prevalence ranged from 25.5% (NV) to 58.7% (NY), but only 4 states were significantly different from the U.S. overall. CONCLUSIONS: Based on this pilot measure, only about 4 in 10 US children ages 3 to 5 years may be considered Healthy and Ready to Learn. Improvement opportunities exist for multiple, modifiable factors to affect young children's readiness to start school.

Automated summary

In 2016, 42.2% of children ages 3-5 in the US were considered Healthy and Ready to Learn, with variations in different domains. Sociodemographic differences were mostly non-significant in the analysis. Health, family, and neighborhood factors were associated with HRL.