Discussion
In this study, we analysed 203 school-going children (105 boys and 98 girls) aged 5–7 years (mean age 5.63 years; SD±0.51). The demographic characteristics of the children are included in tables 1 and 2. Approximately one-third of the total children had scores in lower quantiles in phonological processing and matching letter-like forms. The least mean and median scores were reported in the matching letter-like forms. However, majority of the children had scores in higher quantiles in phonological processing and early number concept. The age of children and lower SES had a negative effect as seen in lower quantiles (25th and below) of school readiness score. The median and higher quantiles of school readiness scores were positively associated with birth weight, and only at 75th quantile, they were associated with parents teaching. Time spent by mother was positively associated only with the 75th quantile of school readiness scores. Negative correlation of school readiness was seen with hospitalisation in the past 3 months in all the quantiles but was more so for lower quantiles (≤25th quantile). A positive association of mother’s education was seen with school readiness in 10th, 50th and 75th quantiles.
School readiness is one of the crucial milestones in child development, but at present, it is neglected globally, including in India.6 In the current study, we used the school readiness subscale of the DAS-II to assess school readiness in the study population. Measuring school readiness is difficult as no widely used and accepted instruments or scales exist. The Australian Early Development Census (AEDC) measures young child development at the start of the first year of school.17 Until now, the AEDC was conducted four times. In the last survey, conducted in 2018, more than 96% of the eligible Australian children were included in the survey.17 The Early Development Instrument (EDI) developed in Canada is a feasible, acceptable and psychometrically sound measurement instrument to assess development health in school.18 In addition to language and cognitive skills measured using DAS-II school readiness, the EDI additionally measures physical health and well-being, social competence and emotional maturity (including behavioural assessment and hyperactivity).18 However, the main challenge with widespread use of these instruments from the Indian context is to translate them in vernacular languages and further validate them.
Phonological awareness refers to an individual’s knowledge that words consist of separate sounds.19 Evidence exists that phonological awareness is the predictor of early number skills. Therefore, the early number concept and phonological skills and working memory are linked in preschool children.19 The same was seen in our study where most (n=97, 47.7%) children had better scores (score 75th quantile or above) in phonological processing and early number concept (n=91, 44.8%). Strong phonological processing is required for successful beginning readers. Both early number concept and phonological processing are affected by training. Primary biological or innate abilities use the approximate number system to help distinguish small from large, big from small, empty from full, and others.20 Primary biological abilities can be improved with deliberate practice to attain secondary biological abilities like counting, making comparisons and performing arithmetic operations.20 The good performance of children in early number concept and phonological skill results may be due to (A) the time spent by the mother with the child and time spent in school, and (B) the time spent by the children in preschool. Moreover, good early number knowledge predicts good school performance in arithmetic tasks, even after controlling for mental ability, memory and intelligence.21 Therefore, the arithmetic performance of our children could be evaluated in additional studies.
Matching letter-like forms can be identified based on visual coding development as suggested by Palmer.22Matching letter-like forms checks for visual perceptions which are needed to learn reading and developing of attention span. Ability to read and attention span are important for learning at school.23 In our study, 62 (30.5%) of the children did not perform adequately (score 25th quantile or below) in matching letter-like forms. Because most (80%) of the children included in our study were aged 5–6 years, they probably used only visual coding and not both visual and phonological coding strategies (dual coding)23 and thus performed poorly in matching letter-like forms.
In our study, the age of children was negatively associated with school readiness scores at lower quantiles (25th and lower). Child age is correlated with math skills, reading skills and learning presocial skills.24 In India, girls are at a disadvantage, especially in terms of access to healthcare and nutrition. However, school readiness might be lower among boys than girls.24 25 This may be because girls have better fine motor skills, perception and perceptual motor skills than boys.26 Lower SES is associated with inadequate school readiness. Children from low-income families tend to experience negative developmental outcomes, including language abilities, working memory, cognitive control, less success in school and lower incomes during adulthood.5 6 17 24 Mother’s education can be a proxy for SES. Children of highly educated mothers scored higher in kindergarten number knowledge, vocabulary, math and reading.27 Furthermore, low birthweight children are at a higher risk of cognitive and school performance problems compared with normal birthweight children, and the risk of adverse outcomes increases as birth weight decreases.28 Low birthweight children are one-third less likely to graduate from high school.28 The cognitive and social skills of children aged 3–7 years can improve if their mothers and other caregivers spend time with them.29 Both education and recreational times have a significant positive effect on cognitive and social skills.29
The AEDC showed that development vulnerability in one or more domains decreased over time with significant gains in language, cognitive and communication skills, and general knowledge.17 However, progress in the domains of physical health and well-being, social competence and emotional maturity fluctuates over time.17 The development venerability of at-risk groups, however, has decreased over time by approximately 6%.17 These findings show that school readiness can be improved in at-risk populations. As India has a large vulnerable population,4 improving school readiness can improve early childhood developmental outcomes.
Methodological consideration
The strength of our study is that we evaluated multiple covariate variables that might be associated with school readiness. A good internal validity was achieved for the school readiness subscale of DAS-II. However, our study has some weaknesses: the DAS-II scale is not validated in the Indian context. We chose urban English-medium schools to avoid translating the school readiness subscale. Therefore, our results are limited to the English-medium schools in a typical middle-class urban setting.