Why Pediatricians are Screening for Literacy

A primary care pediatrician could see a child as many as 15 times before kindergarten, if the American Academy of Pediatrics recommendations are followed. Most of those visits include developmental surveillance or screening.

But approximately 2 out of every 3 children entering a public-school kindergarten in Franklin County are not ready for kindergarten, according to Ohio testing data. Among other concerns, they don’t have the early literacy skills that they should.

This is not just an issue in Ohio. Young child literacy rates have fallen across the country since the COVID-19 pandemic. Nationwide Children’s Hospital is at work on an initiative to change that trajectory, in part through its primary care offices.

“Our current approach does a good job assessing overall development,” says Sara Bode, MD, a primary care pediatrician and medical director of Nationwide Children’s Hospital’s School Health Services. “But it doesn’t consistently capture whether a child is developing the specific literacy skills they need to be ready to learn to read when kindergarten starts.”

Recent research led by Dr. Bode and her colleagues found that nearly half of preschool-aged children were identified as at-risk or needing additional support when screening for early literacy. And now approximately half of Nationwide Children’s primary care clinics are now conducting literacy screening for children as young as 3 years of age with plans to expand systemwide. 

But the hospital’s efforts don’t stop there. Kindergarten Readiness Coordinators work directly with families to create individualized literacy plans, provide hands-on learning materials and connect caregivers to local early childhood resources. These include preschool programs, library-based literacy initiatives and home-based kindergarten readiness programs.

The literacy kits provided to families were developed collaboratively with Columbus City Schools kindergarten teachers and literacy experts to ensure alignment between what children practice at home and what they will see in the classroom.

As NPR, the Associated Press and other national media outlets have reported in recent months, Nationwide Children’s is at the vanguard of this work. In fact, Nationwide Children’s has been working for years to track and improve kindergarten readiness as part of the Pediatric Vital Signs initiative – the large-scale effort to improve child health by measuring certain touchpoints of well-being that can go beyond health, from birth through high school graduation.

Dr. Bode and team are tracking long-term outcomes for children who are participating in literacy efforts, including performance on kindergarten readiness assessments and early academic processes.

“We’re already seeing encouraging early signals,” says Dr. Bode. “Now we want to be sure this intervention truly moves the needle on school success.”