Child, Parent, and Contextual Correlates of School Readiness Among Children With Low Birth Weight

Abstract

Objective

Among US children with low birth weight (LBW) 1) determine prevalence of school readiness; and 2) examine associations between school readiness and medical factors (special health care needs, birth weight), sociodemographic characteristics (child race and ethnicity, household income, parental education, household language), community supports (early intervention/special education, outside childcare, medical home, neighborhood amenities), parent factors (mental health, emotional support, family resilience), and parenting practices (bedtime, mealtime, storytelling routines; daily screentime).

Methods

We studied 1421 children 3 to 5 years with birth weight <2500g from the 2016–19 National Survey of Children’s Health. We calculated the prevalence of school readiness overall and in individual domains (early learning skills, physical health/motor development, social-emotional development, and self-regulation). We investigated associations between predictors and school readiness with logistic regression.

Results

Thirty percent of children with LBW were on-track for school readiness. Domain-specific readiness ranged from 45% in early learning skills to 87% in physical health/motor development. More complex special health care needs (average marginal effect [AME] −17%, 95% confidence interval [CI] −30%, −9%), parental education high school or less (AME −16%, 95% CI −15%, −4%), and early intervention/special education (AME −14%, 95% CI −26%, −5%) were negatively associated with school readiness. Parental emotional support (AME 12%, 95% CI 0.9%, 24%) and <1 hour of daily screentime (AME 16%, 95% CI 6%, 29%) were positively associated with school readiness.

Conclusions

Less than one-third of US children with LBW were on-track for school readiness. Future work should focus on improving school readiness among this population.