Comparison of Literacy and Developmental Screening of Preschool-Aged Children During Primary Care

OBJECTIVE The AAP recommends literacy promotion and developmental surveillance during well care to support school readiness. The Reading House (TRH) is a children’s book-based screener of emergent literacy skills, validated for preschool-aged children. The objective was to compare screening with TRH to a widely used general developmental screening tool during well-visits. METHODS Eligible children (aged 3–4 years, English-speaking household) were screened with TRH and the Survey of Well-Being of Young Children (SWYC) milestones during routine well-visits. TRH screening was performed by Kindergarten Readiness Coordinators, who also provided individualized literacy plans and referrals. RESULTS A total of 721 children completed both the TRH and SWYC milestones screenings. Scores ranged from 0 to 15 (M = 5.12; SD = 3.10) for the TRH and 0 to 20 (M = 15.52; SD = 4.17) for the SWYC milestones and displayed a low positive correlation (r = 0.30). A total of 339 (47.02%) children were flagged as at-risk or needing additional support in some area of development (126 by TRH only, 119 by SWYC milestones only, 94 by both). Of the 508 children who passed the SWYC milestones, there were 126 who failed TRH (24.8%). Logistic regression models indicated sociodemographic factors associated with the likelihood of being flagged as at-risk on each respective screening test (race, sex, Child Opportunity Index). CONCLUSIONS TRH identified a substantial number of children at-risk who passed general developmental screening (SWYC milestones). This study expands validation evidence of TRH and reinforces the value of emergent literacy screening at this formative age.