Factors associated with low school readiness, a linked health and education data study in Wales, UK

Abstract

AbstractBackgroundSchool readiness is a measure of a child’s cognitive, social, and emotional readiness to begin formal schooling. Children with low school readiness need additional support from schools for learning, developing required social and academic skills, and catching-up with their school-ready peers. This study aims to identify the modifiable risk factors associated with low school readiness using linked routine data for children in Wales.MethodThis was a longitudinal data linkage cohort study. The cohort comprises of children who completed the Foundation Phase assessment between 2012 and 2018. Individuals were identified by linking Welsh Demographic Service and Pre16 Education Attainment datasets. School readiness was assessed via the binary outcome of the Foundation Phase assessment (achieved/not achieved). This study used multivariable logistic regression model and decision tree to identify and weight the most important risk factors associated with low school readiness.ResultsIn order of importance, logistic regression identified maternal learning difficulties (adjusted odds ratio 5.35(95% confidence interval 3.97-7.22)), childhood epilepsy (2.95(2.39-3.66)), very low birth weight (2.24(1.86-2.70), being a boy (2.11(2.04-2.19)), being on free school meals (1.85(1.78–1.93)), living in most deprived area (1.67(1.57–1.77)), maternal death (1.47(1.09-1.98)), and maternal diabetes (1.46(1.23 - 1.78)) as factors associated with low school readiness. Using a decision tree, eligibility for free school meals, being a boy, absence/low attendance at school, being a younger child (e.g., August born), being born low birth weight, and not being breastfed were factors found to be associated with low school readinessConclusionThis work suggests that public health interventions focusing on children who are: boys, living in deprived areas, have poor early years attendance, have parents with learning difficulties, have parents with an illness or have illnesses themselves, would make the most difference to school readiness in the population.