Pediatricians’ attitudes, practices, and perceived barriers to school readiness.

Background. School readiness (SR) has been adopted by the American Academy of Pediatrics (AAP) as a component of health supervision, but the medical community’s role is unknown. We evaluated the pediatricians’ attitudes, practices, and perceived barriers to SR. Methods. This multicenter, cross-sectional descriptive study was performed among 787 general pediatricians, pediatric residents, subspecialists, and subspecialty fellows. A 41‐item survey was administered. Results. Forty-nine point two percent of the pediatricians defined SR as a multidimensional issue, as outlined by the AAP, whereas 50.8% defined it as the child’s set of skills or passing the SR tests. Three-quarters of pediatricians believed that SR assessment tests are necessary before starting school, and children who do not appear ready should wait a year. To promote SR, the rates of usually fostering at least four of the five “Rs” (reading, rhyming, routines, rewarding, relationships) and integrating developmental surveillance into daily practice were 37.8% and 23.8%, respectively. Only 2.2% of pediatricians usually inquired about eight adverse childhood experiences (ACEs), and 68.9% did not usually ask about any. Usually fostering at least four of the five “Rs” was associated with usually integrating developmental surveillance (p<0.001), usually inquiring about each ACE (p<0.001), and being perceived as responsible for promoting SR (p<0.01). Training on SR during pediatric residency was 2.7%. Time constraints and insufficient knowledge were the most common barriers. Conclusions. Pediatricians were not familiar with the concept of SR and had some misconceptions. There is a need for additional training regarding pediatricians’ roles in promoting SR along with addressing multiple, modifiable barriers within the health system. [ABSTRACT FROM AUTHOR]