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At just 3 years old, Quintina Davis鈥� 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.

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

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

At six of Nationwide Children鈥檚 Hospital鈥檚 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.

鈥淲hen kids come into their primary care pediatrician, if they鈥檙e coming into all of their checkups, they would come in 15 times before they start kindergarten,鈥� said Sara Bode, medical director of school-based health at Nationwide Children鈥檚. 鈥淭hat 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.鈥� 

The 5-minute screenings are done annually at the beginning of a regular check up by a team of 鈥淜indergarten Readiness Coordinators,鈥� 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鈥檚 letter and shape recognition, rhyming and fine motor skills 鈥� like turning a page. Afterward, they鈥檙e 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.

鈥淲e have light bulb moments. 鈥� One is in a good way when we do this literacy screening and the child is knocking it out of the park 鈥� and the parents are like 鈥業 didn鈥檛 even know they could do this,鈥欌�� Bode said. 鈥淎nother light bulb moment is when kids are struggling and parents will say to us 鈥業 had no idea they were supposed to know these things before kindergarten,鈥� and we鈥檙e like 鈥楾hat鈥檚 OK. That鈥檚 why we鈥檙e doing this now, because at the age of 3 鈥� you have all the time in the world.鈥� 鈥�

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.

鈥淢ost of our parents, if you ask them, 鈥榃hat should your child know? What are those early literacy skills before kindergarten?鈥� they can鈥檛 really tell you,鈥� Bode said, 鈥淪o, this is just a real learning opportunity.鈥�

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

鈥淚 didn鈥檛 know where to start,鈥� Davis said, adding that while she read to her granddaughter often, she didn鈥檛 feel like she 鈥渉ad the right materials to get her started the right way.鈥�

鈥淲hen you鈥檙e at home, you just think of things that you think the child would need to know, but with a coordinator, 鈥� you鈥檙e given things you should be working on. 鈥� It鈥檚 good to know I鈥檓 not jumping ahead or giving her too much that she doesn鈥檛 need now,鈥� Davis said. 鈥淭he screening really helped me get focused and to engage more with my granddaughter with different techniques.鈥�

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 鈥渕any kids who are really struggling on these assessments.鈥�

鈥淭hese 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,鈥� Bode said.

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

In Ohio, kindergarten students are required to take a 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鈥檚 average of 60%.

In the 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.

鈥淲e’re getting these kids connected because these are some of our highest risk populations,鈥� Bode said. 鈥淲e’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.鈥�

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

鈥淪he has grown from knowing her name to writing her full name. 鈥� She writes A through Z. She knows her sight words. She can write her birthday,鈥� Davis said. 鈥淛uri has an advantage because [our clinic] saw she was ready at 3. 鈥� By the time she gets to kindergarten, she鈥檚 going to be ready. She鈥檚 going to be advanced.鈥�

Bode is hopeful the screenings will expand to all of the hospital鈥檚 13 locations and that it鈥檒l work with national initiatives like , a program that gives children books at every pediatric visit and , which gifts kids books from birth to 5.

鈥淭here’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,鈥� Bode said. 鈥淪o this idea of mixing health and education is just so important 鈥� 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.鈥�

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