Universal Kindergarten Health Screening: Associations with School Readiness

• In Event: Poster Session 13
  In Poster Session: PS 13 Topic - School Readiness/Childcare

Abstract

Introduction.
Physical health and wellbeing are widely recognized as important determinants of kindergarten readiness (e.g., Basch, 2011). Previous research has demonstrated the effects of prenatal and maternal health factors (e.g., low birth weight) and chronic diseases (e.g., asthma, lead poisoning) on early educational outcomes (e.g., Currie, 2005; Peterson et al., 2018) and estimated that racial/ethnic differences in such health conditions may account for as much as 25% of racial/ethnic disparities in school readiness (Currie, 2005). Comparatively less is known about how common health risks like being tired, hungry, or sick during the school day relate to kindergarten readiness in community samples of young children attending urban public schools. The current study leverages teacher report of three health risks (tiredness, hunger, and sickness) on a routinely administered district-wide kindergarten readiness screener to (1) document the prevalence of the three health risks; (2) identify demographic inequities in children’s health status; and (3) examine the unique links of each teacher-reported health risk with academic and social-emotional skills over and above demographic characteristics.

Method.
The sample consisted of the entire population of 12,415 kindergarteners with school readiness data collected in 2017–2018, 2018–2019, and 2019–2020. These students were drawn from 73 schools in a large urban school district in California’s San Francisco Bay Area and were linguistically and racially/ethnically diverse (see Table 2, Note).

Kindergarten teachers reported on students' health risks and assessed students' readiness skills during the first six weeks of school. Health questions included whether students appeared tired, indicated they were hungry, or were sick in class. School readiness skills included three directly assessed literacy items (e.g., letter recognition; alpha = .78), three directly assessed cognitive/motor items (e.g., counting to 20; alpha = .73), and three teacher observed social-emotional items (e.g., curiosity; alpha = .75). Student demographic characteristics obtained from school administrative records were included as covariates.

Results.
As illustrated in Table 1, 14% of students were reported to regularly experience hunger; 18% tiredness; and 6% sickness. Health risks were intercorrelated and were disproportionately concentrated among special education students and Black and Latinx students. Accounting for demographic characteristics, each health risk was uniquely associated with literacy, cognitive/motor, and social-emotional skills (ps < .001), with tiredness demonstrating the largest relative effect. Multigroup models showed that associations of the three health risks with the three readiness domains were all invariant across student race/ethnicity.

Discussion.
This study demonstrates the feasibility of using routinely collected teacher reports to identify students’ health concerns earlier than the medical system likely could. The finding that teacher-reported hunger, tiredness, and sickness each explain significant variability in kindergarten readiness, above and beyond the demographic factors typically used to assess disadvantage, suggests that efforts to redress inequalities in early learning should attend to students’ health-related needs. Moreover, given the demographic disparities found in health risk exposure, districts and communities should target resources to students who are disproportionately vulnerable. School-based universal basic health screening holds promise for efforts to enhance equity in learning opportunities at the critical transition to kindergarten.

Authors

• Lily Steyer, Stanford University
  Presenting Author

• Michael J. Sulik, Stanford University
  Non-Presenting Author

• Carrie Townley-Flores, Stanford University
  Non-Presenting Author

• Jelena Obradovic, Stanford University
  Non-Presenting Author