An Ohio Hospital Is Screening Young Kids for Reading and School Readiness

At just 3 years old, Quintina Davis’ granddaughter, Juri, could name colors, numbers and shapes.

Davis often heard from family and friends that Juri was smart and she should consider enrolling her granddaughter in preschool early.

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And a new literacy screening at one of her granddaughter’s primary care checkups confirmed it.

In recent years, literacy has become an issue that’s extended far beyond the classroom and a child’s home, reaching government — and now hospitals.

At six of Nationwide Children’s Hospital’s 13 clinics, in Columbus, Ohio, 3 to 5 year olds are receiving reading screenings during their pediatric visits. Since 2022, more than 7,000 children have received the screenings.

“When kids come into their primary care pediatrician, if they’re coming into all of their checkups, they would come in 15 times before they start kindergarten,” said Sara Bode, medical director of school-based health at Nationwide Children’s. “That was a really opportune setting for us to really think about where we are in intervening, assessing or understanding where kids are with their literacy and supporting that from the clinic.” 

The 5-minute screenings are done annually at the beginning of a regular check up by a team of “Kindergarten Readiness Coordinators,” who are former early childhood educators and now work at the hospital.

The screening does not check for learning disabilities, but can identify some challenges with language development. The screening mainly focuses on foundational skills that are learned at home through activities like reading with a parent before bed or letter games.

By doing a small read aloud with a board book, the coordinators assess a child’s letter and shape recognition, rhyming and fine motor skills — like turning a page. Afterward, they’re able to tell parents if their child is ahead, on track or needs additional support, providing an opportunity for early intervention well before a child enters a formal classroom setting.

“We have light bulb moments. … One is in a good way when we do this literacy screening and the child is knocking it out of the park … and the parents are like ‘I didn’t even know they could do this,’” Bode said. “Another light bulb moment is when kids are struggling and parents will say to us ‘I had no idea they were supposed to know these things before kindergarten,’ and we’re like ‘That’s OK. That’s why we’re doing this now, because at the age of 3 … you have all the time in the world.’ ”

The coordinators provide learning kits with different reading materials including magnetic letters and activity books. Coordinators maintain a relationship with families in the weeks, months and years to come, with additional resources like care coordination to get students enrolled in preschool, access to library readings and where to find adult education programs if a parent struggles with reading.

Families are given a personalized literacy plan, with checklists for parents to go over where their child is performing well and where they can improve. Check-ins after the initial screening occur a month and three months later, with updated assessments when the child turns four and five.

“Most of our parents, if you ask them, ‘What should your child know? What are those early literacy skills before kindergarten?’ they can’t really tell you,” Bode said, “So, this is just a real learning opportunity.”

For families, like Davis, the guidance is a helpful launching pad.

“I didn’t know where to start,” Davis said, adding that while she read to her granddaughter often, she didn’t feel like she “had the right materials to get her started the right way.”

“When you’re at home, you just think of things that you think the child would need to know, but with a coordinator, … you’re given things you should be working on. … It’s good to know I’m not jumping ahead or giving her too much that she doesn’t need now,” Davis said. “The screening really helped me get focused and to engage more with my granddaughter with different techniques.”

The majority of the children are from low-income backgrounds, Bode said, adding that the primary care clinic serves more than 85% of people and families who are on Medicaid or uninsured with “many kids who are really struggling on these assessments.”

“These clinics are all chosen because they’re in locations where, typically, we can tell by the school district, that a lot of the kids don’t start school ready,” Bode said.

Across Columbus Public Schools, about 64% of third grade children are not reading on grade level, according to state data, but hospital staff are hopeful early intervention is beginning to move the needle.

In Ohio, kindergarten students are required to take a readiness test at the beginning of the school year that measures social-emotional development, physical well-being and skills in literacy and math.

Recent data from the hospital found its first cohort of 332 students had over a 71% passage rate compared to the district’s average of 60%.

In the Linden neighborhood of Columbus, a predominately Black and low-income area, only 22% of children pass the readiness assessment on average, but children who partook in the screening process were over 70%, Bode said.

“We’re getting these kids connected because these are some of our highest risk populations,” Bode said. “We’re really seeing gains where we’re able to intervene, connect them to programs, teach parents what to do at home and it’s actually now translating to their language and literacy scores when they get to kindergarten.”

With the help of the kindergarten readiness coordinators, Juri has been enrolled in a local preschool for a year, where she’s ahead of the curriculum.

“She has grown from knowing her name to writing her full name. … She writes A through Z. She knows her sight words. She can write her birthday,” Davis said. “Juri has an advantage because [our clinic] saw she was ready at 3. … By the time she gets to kindergarten, she’s going to be ready. She’s going to be advanced.”

Bode is hopeful the screenings will expand to all of the hospital’s 13 locations and that it’ll work with national initiatives like Reach Out and Read, a program that gives children books at every pediatric visit and Dolly Parton’s Imagination Library, which gifts kids books from birth to 5.

“There’s a big difference between not being delayed and being ready for school and thriving, and I do think there’s a gap and misunderstanding in the medical field about what is needed,” Bode said. “So this idea of mixing health and education is just so important … because if a kid’s not ready for kindergarten, then they are more likely to fail that third-grade reading test, then they’re less likely to graduate and their adult health outcomes are probably more affected by that than anything I’m treating in the clinic.”