Healthy and Ready to Learn: National and State Data on 3-Year-Old Development

For the first time, national data can offer a holistic view of 3-year-olds’ developmental well-being. The Healthy and Ready to Learn (HRTL) measure, developed for use in the National Survey of Children’s Health (NSCH), captures young children’s development in five domains: early learning skills, social-emotional development, self-regulation skills, physical health, and motor skills. Together, these domains indicate whether young children are developmentally “on track” before entering kindergarten.

Three-year-olds sit at the transition from toddlerhood to preschool, so data on this age group can inform how well prenatal-to-three investments are working and guide decisions regarding how best to support preschoolers and a successful start to school. The HRTL data can also be used to understand how family, community, and policy contexts influence developmental well-being.

The NSCH is a national annual survey completed by parents, the data from which provide state- and national-level insights into many aspects of children’s health and well-being. In the data dashboard and resources below, we highlight the developmental well-being of 3-year-olds.

3-Year-Old Data Dashboard

This dashboard presents the latest HRTL data from the NSCH, showing the developmental well-being of 3-year-olds in the United States. It presents the percentage of 3-year-olds who are developmentally “on track” in each domain and on an overall, summary measure of HRTL. Use the dashboard to explore your state’s data or take a national view.

Data are from the combined 2023 and 2024 National Survey of Children’s Health datasets, which are nationally and state-representative surveys completed by U.S. parents of children from birth to age 18. The 2023 sample includes 4,005 respondents representing 3,783,493 3-year-olds and the 2024 sample includes 2,462 respondents representing a total of 3,773,897 3-year-olds. Graphs display the weighted estimates with 95% confidence intervals.

A Different Look at HRTL: The Number of Domains On Track and Needs Support 

Another way to understand the national and state HRTL estimates is by examining how many domains on which children score either “on track” or “needs support” (the lowest of the three scoring categories, with “emerging” as the middle category). While the percentage “on track” overall and by domain is one useful way of understanding children’s development at the national and state levels, it’s also possible to see the percentage of children who are “on track” in all domains or in none, along with the percentage who score “needs support” in two or more domains.  

This also helps clarify how the overall HRTL measure is scored. To receive an overall “on track” score, a child must be “on track” in 4 or 5 domains, and have no domains for which they score “needs support.” The tables below present national and state data showing the percentage of children “on track” in 5, 4, 3, 2, 1, or 0 domains, as well as the percentage scoring “needs support” in 2 or more domains. 

3-Year-Olds’ National Trends Over Time

The final, validated version of the HRTL measure was first included in the 2022 NSCH, presenting three years of data on 3-year-olds’ development. The NSCH is collected annually, so HRTL data are also available annually. These graphs show national data from 2022-2024, highlighting trends in the percentage “on track” on the overall summary measure and across the five domains for 3-year-olds.

Data are from the 2022, 2023, and 2024 National Survey of Children’s Health, which are nationally and state-representative surveys completed by U.S. parents of children from birth to age 18. The 2022 sample includes 3,766 respondents representing 3,890,288 3-year-olds, the 2023 sample includes 4,005 respondents representing 3,783,493 3-year-olds, and the 2024 sample includes 2,462 respondents representing a total of 3,773,897 3-year-olds. Graphs display the weighted estimates with 95% confidence intervals.

Frequently Asked Questions