Immediate Effects of a Program to Promote School Readiness in Low-Income Children: Results of a Pilot Study.

Children from low-income backgrounds demonstrate poorer school readiness skills than their higher-income peers. The Kids in Transition to School (KITS) Program was developed to increase early literacy, social skills, and self-regulatory skills among children with inadequate school readiness. In the present study, 39 families participated in a pilot efficacy trial conducted through a community collaboration to examine the feasibility and impact of the KITS program with families from disadvantaged neighborhoods. Participating families were demographically representative of the larger populations in the participating school districts. Children who received the intervention demonstrated significantly greater improvements in letter naming, initial sound fluency, and understanding of concepts about print than their peers who did not participate in the intervention, as well as decreases in aggressive responses to peer provocation and increases in self-regulation skills. Results suggest that a brief, focused school readiness intervention is feasible to conduct with low-income families and may improve critical skills.

Lowering developmental screening thresholds and raising quality improvement for preterm children.

OBJECTIVES: To determine: 1) if preterm children were referred, identified and received early intervention (EI)/ early childhood special education (ECSE) services at rates equivalent to term children after implementation of a universal, periodic Ages and Stages Questionnaire (ASQ) surveillance and screening system; 2) if pediatricians sufficiently lowered their screening thresholds with preterm children;and 3) if quality improvement opportunities exist. PATIENT AND METHODS: Secondary analysis was performed on 64 lower-risk, mostly late-preterm and 1363 term children who originally presented to their 12- or 24-month well- visits. Higher-risk preemies already involved with an EI agency/ identified with a delay were excluded. Board-certified pediatricians (N=18), and nurse practitioners (N = 2), blind to the ASQ results, were secondary participants. Differences between preterm and term developmental agency referrals were examined comparing Pediatric Developmental Impression to the ASQ under natural clinic conditions using a combined in-office or mail-back data collection protocol. Medical record and county EI/ECSE follow-up outcomes were conducted at 36 to 60 months. RESULTS: At 12 and 24 months, preterm (versus term) referral rates were 9.5%(versus 5.6%) with Pediatric Developmental Impression and 26.2% (versus 8.1%) with the ASQ. By 36 to 60 months, 37.5% of preterm (20.8% term) children were referred to EI/ECSE; of which, 50.0% of preterm (42.4% term) children were eligible for services, 54.2%of preterm children were identified with a developmental-behavioral disorder and 29.2% of preterm (20.8% term) children did not follow-up. For ASQ-only preterm referrals,55.6% were subsequently diagnosed with a developmental delay and/or disorder.Preterm children were 2 times more likely to be eligible than term children [corrected]. CONCLUSIONS: Combined referral, quality improvement and outcome data suggests that clinicians should lower their threshold for administering a psychometrically sound developmental screen when providing surveillance for ex-preemies. Quality improvement opportunities exist with diligent developmental surveillance and a more collaborative, standardized, reliable and interpersonal referral process.