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School Readiness of Young Children Enrolled in Preschool in the United States. OBJECTIVE: As preschool enrollment increases, it is important to know whether children enrolled in preschool are more likely to be "healthy and ready to learn (HRTL)." Our objective was to assess whether there are detectable school readiness differences between children enrolled in preschool and those who are not in a large, cross-sectional, nationally representative US sample. METHODS: Caregivers of 4931 3- to 4-year-old children in the 2016 National Survey of Children's Health indicated whether their child had started school and completed questions forming the "HRTL" School Readiness National Outcome Measure and its domains: early learning skills, self-regulation, social-emotional development, and physical health/motor development. Propensity score-matched logistic regression models estimated prevalence ratios (PRs) comparing children in versus not in preschool. RESULTS: 49.1% of children had started preschool. After matching, children in preschool did not differ from children not in preschool on the composite (PR = 1.21; 95% confidence interval [CI]: 0.92-1.58) or any domains. Children in preschool were more likely to be "on track" with rhyming words (PR = 1.48; 95% CI: 1.11-1.96), writing their name (PR = 2.36; 95% CI: 1.82-3.08), and holding a pencil (PR = 1.55; 95% CI: 1.12-2.14) but less likely with explaining things they have seen/done (PR = 0.59; 95% CI: 0.44-0.79) and overall health (PR = 0.57; 95% CI: 0.33-0.97). Some associations were sex specific. CONCLUSION: The largely null findings of this study underscore the need for further research that incorporates information regarding the extent and quality of preschool exposure when evaluating the developmental benefits of preschool on a national level.