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Original research
Assessment of school readiness of children and factors associated with risk of inadequate school readiness in Ujjain, India: an observational study
  1. Shreya Shrivastava1,
  2. Vandana Patil1,
  3. Madhavi Shelke2,
  4. Madhura Anvikar2,
  5. Aditya Mathur1,
  6. Ashish Pathak1,3,4
  1. 1Pediatircs, RD Gardi Medical College, Ujjain, India
  2. 2Neurodevelopment, Integrated Center for Child Neurodevelopment (ICON), Aurangabad, India
  3. 3Global Health–Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  4. 4Department of Women and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Ashish Pathak; ashish.pathak{at}


Objective School readiness is a condition or state indicating that the child is ready to learn in a formal educational set-up. The objective of this study was to estimate the prevalence of and factors associated with school readiness in urban schoolchildren in Ujjain, India.

Methods This cross-sectional study was conducted from February 2016 to March 2017. Two English-medium schools were conveniently selected. All children aged 5–7 years were eligible to participate. A subscale of Differential Ability Scales-Second Edition, namely ‘school readiness scale’, was used to assess school readiness in three major domains—early number concept, matching letter-like forms and phonological processing. Data on factors associated with school readiness were collected through parent interview. Quantile regression analysis was used to explore school readiness scores.

Results This study included 203 school-going children (105 boys and 98 girls) having a mean (SD) age of 67.7 (±0.51) months. The phonological processing and matching letter-like forms had 31.5% and 30.5% children, respectively, in lower quantiles (≤25th). The higher quantile (≥75th) scores were achieved for phonological processing and early number concept (47.7% and 44.8% children, respectively). The results of quantile regression showed negative association of school readiness scores with age of children, lower socioeconomic status and hospitalisation status, especially in the lower quantiles (≤25th). The 10th, 50th and 75th quantile scores were positively correlated with the increasing education status of the mother. Birth weight was positively associated with the median and higher quantile scores (≥75th).

Conclusions School readiness in a middle-class urban setting in India was negatively associated with lower age of the child, lower socioeconomic status, hospitalisation and positively correlated with increasing birth weight and maternal education. Lower quantile scores were achieved in matching letter-like forms, which measures complex visual–spatial processing, and phonological ability, which correlates with acquired verbal concepts. Focused interventions are needed to improve these skills.

  • school readiness
  • urban children
  • risk factors
  • India

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  • Contributors AP conceived the idea and is the guarantor of the study. SS and VP collected the data. MS, MA, AM and AP supervised the collection of the data. SS, VP, MS, MA, AM and AP carried out data management. SS, MS, MA, AM and AP analysed the data. SS and AP drafted the manuscript. SS, VP, MS, MA, AM and AP read the drafts and provided feedback. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval The Institutional Ethical Review Board of RD Gardi Medical College, Ujjain, India, approved the study (IEC Ref No-459/2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

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