534 - School Readiness Screening in Primary Care Pediatrics

Publication Number: 4522.534

Emily Davis, Hasbro Children's Hospital at Rhode Island Hospital, Providence, RI, United States; Kate L. Salguero Lizarraga, The Warren Alpert Medical School of Brown University, Stoughton, MA, United States; Paulo R. Pina, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Caitlin F. Canfield, NYU Grossman School of Medicine, New York, NY, United States

Background: School readiness (SR) is the development of physical, cognitive, and social-emotional skills necessary for success in kindergarten and beyond. Only about 4 in 10 U.S. children ages 3–5 years are considered ready to learn. Low levels of SR have been linked to future adverse outcomes, including lower high school graduation rates, reduced employment stability, and increased contact with the criminal justice system. Pediatric primary care offers a valuable touchpoint to identify strengths and needs before school entry, yet SR screening is rarely implemented due to competing demands and lack of standardized tools.

Objective: To explore parental and provider understanding of SR and perceptions of screening for SR in a pediatric primary care practice.

Design/Methods: Separate focus groups were conducted with English- and Spanish-speaking parents of children ages 3–4 (n=19) and pediatric providers, nurses, medical assistants, and ancillary staff (n=16) across primary care clinics in two U.S. cities. Discussions were audio-recorded, transcribed, and analyzed using a thematic analysis approach. Coding was conducted iteratively by multiple reviewers until thematic saturation was achieved.

Results: Findings from both parent and provider groups highlighted agreement that SR includes social-emotional skills that support independence, learning, and navigating peer interactions, language and communication skills, physical readiness (i.e., potty-trained), and basic cognitive skills. Parents expressed a desire to learn proactive strategies to support their child’s school preparation and identified pediatricians as trusted sources of guidance and resources. Both parent and provider groups demonstrated support for SR screening within the primary care setting. Providers noted barriers to SR screening include time, lack of guidelines on when and how to screen, and need for more information about local schools (i.e., registration process).

Conclusion(s): Understanding parental and provider perspectives on SR screening is critical to designing equitable, feasible interventions in primary care that can help close early developmental gaps and promote long-term educational success. Both parents and providers described SR as being multifactorial, with a particular emphasis on social-emotional skills. Both groups also agreed that screening for SR in a proactive manner in primary care settings would benefit children and their families, especially as it would allow families to be connected with relevant resources and supports. Next steps include the development and piloting of a practical SR screening tool in diverse pediatric settings.