A new population-level measure shows promise for identifying young children who are healthy and ready to learn

BlogEarly ChildhoodJun 30 2020

Child Trends cares deeply about developing measures and using data to understand and track progress toward well-being among children across racial, economic, and social groups. As Child Trends’ president Carol Emig recently said, we hope that this moment in history will mark a turning point for the nation in the fight against racism and injustice. As we begin the work of building better public systems for children and families post-pandemic, we must put equity at the center of those efforts. We believe that having a measure of Healthy and Ready to Learn for states and the nation is an example of the potential power of data to advance equity-minded and evidence-informed efforts to overcome the effects of racism that affect preschool children.

Researchers at Child Trends, partnering with the Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB), developed a new parent-reported measure of Healthy and Ready to Learn (HRTL) for preschoolers ages 3 to 5. This measure is collected annually via the National Survey of Children’s Health (NSCH) and describes development for children across four domains, including Early Learning Skills, Self-Regulation, Social-Emotional, and Physical Health. Children are scored as “On Track” in each domain, and an overall measure indicates whether children are “On Track” in all four domains, three, two, or one to no domains. 

The skills children gain before starting kindergarten set the stage for their future success in school. While there are several tools that measure individual children’s readiness for kindergarten, there has been, until now, no comprehensive, population-level tool that can tell us about children’s competencies prior to kindergarten. A population-level tool would identify groups of children who need more support, inform program and policy decisions, and show us trends in children’s skills over time.

The pilot National Outcome Measure, Healthy and Ready to Learn (HRTL), shows promise as a valid population-level tool that can describe the school readiness of young children ages 3 to 5 across developmental domains—including the important domains of social-emotional and self-regulation development, for which there are only limited assessments. In one indication of the new measure’s validity, children’s HRTL scores are clearly and strongly associated with social, economic, and family circumstances in ways that are consistent with previous research. For example, as shown in four briefs, children in economically disadvantaged families and neighborhoods are less likely to be healthy and ready to learn in all four domains. These findings highlight the promise of HRTL to detect population-level patterns and trends in preschoolers’ school readiness, where previously no such measure was available for states or the nation. Indeed, having a valid population-level tool to assess school readiness can reveal new opportunities for researcher-community partnerships and activities that inform state policies, programming, and budgeting to most effectively serve children’s needs.

Importantly, several factors that are within families’ control are positively associated with children being healthy and ready to learn. For example, routines—such as consistent bedtimes and mealtimes, and ensuring that children get 10 or more hours of sleep daily—are positively related to HRTL scores. In addition, parents who reported regularly reading, singing, and telling stories with their children were more likely to rate their children as healthy and ready to learn. Children who had two or more hours of screen time per day were less likely to be rated as healthy and ready to learn. Focusing on adjustable family factors can raise awareness about what families can do to support their young children’s development and their learning prior to kindergarten. At the same time, income and factors related to income, such as food security and neighborhood characteristics, are also related to being healthy and ready to learn.

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The promise of HRTL as a population-level National Outcome Measure that can be used by early care and education stakeholders, policymakers, and researchers will be enhanced by additional measure refinement and validity testing. (Validity testing examines the extent to which a tool accurately measures what it intends to measure). With input from a multidisciplinary technical expert panel, Child Trends and HRSA MCHB have proposed revisions to the measure ranging from minor edits to the addition of new items. The revised set of items is undergoing testing by the National Center for Health Statistics (NCHS) to ensure that the items are comprehended similarly across parents with preschool children of various ages and from a variety of backgrounds. Revised items will be included in future versions of the NSCH, potentially as soon as the 2021 survey.

Ideally, validity testing should culminate in a prospective validity study. Such a study would follow children as they transition into kindergarten and elementary school to assess whether the HRTL accurately predicts their academic performance. If state-level data on HRTL do, in fact, predict children’s later school success, this knowledge can provide needed information to understand variations in child readiness across HRTL domains at the national and state levels—including the ability to examine subgroups of children. This knowledge can then be used to understand which groups of children may benefit from additional resources to help them be healthy and ready for school.