Profiles of School Readiness in Very Preterm Children
by Dr. Gehan Roberts
Developmental-Behavioural Paediatrician, Royal Children’s Hospital, Melbourne
Very preterm children (those born at less than 32 weeks of gestation) account for 1-2% of all births. Although most of these children do not have severe developmental or physical difficulties (such as severe cerebral palsy, deafness or blindness), about 1in 2 will have school age academic or behavioural difficulties.
Early intervention in the preschool period has been shown to lead to improved long-term outcomes in other at-risk groups of children, but has not been studied in preterm children. We studied the patterns of school readiness skills of very preterm children, as early identification of difficulties prior to starting school will allow specific early intervention that may result in long-term benefits.
141 children participated in our study: 119 who were born very preterm and 22 term children as a comparison group. Using tests and parent questionnaires that were administered to each child over about 60 minutes, we examined five developmental skill areas that are vital for children to start school ready to learn.
These areas were:
- Health and physical development: children need to be healthy to attend school regularly, and physical skills are also important predictors of academic achievement.
- Emotional well-being and social competence: these abilities are important to be able to transition from kindergarten into the routine and rule-based school environment, and to allow the development of friendship networks.
- Communication skills: these skills are needed to allow the child to understand the subject matter presented to them, to display their knowledge and to communicate with peers. Language skills are strongly correlated with literacy skills.
- Approaches to learning: memory, attention and self-control are important in allowing the child to learn in a classroom. Both literacy and numeracy skills are dependent upon competence in this area.
- Cognitive skills and general knowledge: these skills are dependent upon the child’s learning in the preschool period. In children who have had less cognitive stimulation in the early years, these skills can also develop rapidly in the early school years, especially if the child is competent in the other four skill areas.
When the results from each area are examined individually, the data are encouraging: in each the first four areas, between 60 and 80% of preterm children had skill levels in the normal range. In the approaches to learning area, however, only 40% of the preterm children had skill levels in the normal range. Compared with the term children, many more preterm children had difficulties in school readiness skills overall, emphasising the need for a thorough understanding of their strengths and vulnerabilities prior to starting school. These results show that it is important that very preterm children have a comprehensive school readiness assessment so that their individual learning profiles can be clearly understood and supported as they start primary school.
For example, children with communication difficulties may benefit from speech therapy and those with social emotional difficulties, from a consistent and positive behavioural plan in the classroom. We now hope to use this information to design early intervention studies aimed at preventing long-term difficulties at school-age and beyond. For more information about the importance of families, communities and schools in supporting school readiness, please refer to the recent policy brief from the Centre for Community
Child Health at the Royal Children’s Hospital:
www.rch.org.au
If you are concerned about whether your child is ready to start school, then it is important to get advice that can support you in making this decision. You should talk to the preschool/ kindergarten teacher, the primary school teachers, and other health professionals; they can assist in assessing your child’s development and readiness for school.
Some simple activities that you can do to help your child get ready for school:
www.rch.org.au
- Read to your child and use books as a pleasurable daily shared activity
- Make everyday things an exploration of language: ask the child questions, listen carefully to their answers, and encourage the child to ask why.
- Encourage the child’s natural curiosity
- Do different things with them, encourage them to try different ways of doing things. Make a walk in the park a nature tour.
- Encourage the child to learn to dress and undress independently, and use the toilet appropriately.
- Make sure the child has crayons and pencils and a supply of paper to draw and write on, and always praise their efforts.
- Encourage your child to mix with other children in different supervised activities so they learn to socialize with their peers, take turns and share their toys and books.
Talking with schools
When you‘re talking to schools that you are considering for your child, be sure that you cover:
- your child’s strengths and abilities
- your child‘s needs and any challenges or barriers he/she might face at school
- adjustments that the school could make to deal with these challenges and barriers and whether these adjustments are reasonable.
School Readiness for Children with disabilities
Many children with disabilities now go to an ordinary school, but whether they go to an ordinary school or a special school, schooling is a large part of their lives and it is important that it works well for them.
Some school difficulties can be:
- not having appropriate physical needs eg ramps for wheelchairs, suitable desks or computers,
- teachers not understanding the condition,
- missing school and losing touch with friends,
- having to spend a lot of ‘free’ time catching up with work, and
- bullying and teasing.
Some things you can do to help
- Check out the school first and make sure it is suitable for your child. Take your child with you.
- Check with the school about extra resources which might be available for your child from educa-tion, health or other agencies eg support staff, physical needs like computers etc.
- Help your child to learn to manage her own clothes and needs as far as possible so she can feel and be independent.
- Find out what school activities your child can take part in eg drama, music and outings. Being part of things can make children feel much happier and more confident.
- It may help to have a health professional come to the school and talk to the children and the staff about your child’s health problem.
- Try to arrange health/medical appointments during school holidays so your children miss as little school as possible.
- Talk to the teachers so they understand your child’s needs and abilities. Let the teachers know if tiredness or pain or coordination problems make it hard for her to do some of the tasks. All her teachers need to know about this, not just classroom teachers. Support from teachers is very im-portant.
- Friends can be very important for your child in many ways so encourage friendships where you can and make it easy for your child‘s friends to visit you.
Mainstream schools
All children over six have to go to school. Families of children with disabilities can choose where their child goes: the local government school, a special school or separate classes (if available).
If you‘re thinking of enrolling your child at the local government school, you need to contact the school well before the enrolment date. You‘ll need to give the school documented evidence about your child’s disability, such as information provided by your doctor or by a specialist who was involved in the diagnosis. The school will use this information to make an assessment about the services your child would need to function well in school.
Applications for additional funding need to be submitted as early as May to July prior to the year of commencing school. An Educational Needs Questionaiire (ENQ) will need to be completed in collabera-tion with parents and the school principal/teachers for services and resources including:
- teacher‘s aides
- special equipment to improve physical access
- allied health services such as occupational therapy or speech pathology services.
Non-government schools, such as private schools and Catholic schools are subject to the same laws, and have policies and programs similar to those in government schools to help school children with dis-abilities. Contact these schools directly to find out about their programs.
Where to get assistance
If you are concerned about whether your child is ready to start school, then it is important to get advice that can support you in making this decision. You should talk to the preschool/ kindergarten teacher, the primary school teachers, and other health professionals; they can assist in assessing your child‘s development and readiness for school.
Most children attend primary school close to home. For state primary schools, a child is allocated a school in the neighbourhood zone where they live. Neighbourhood schools have an obligation to accept any student who lives in their zone.
For more information download the Parent’s Guide to Victorian Government Primary Schools. To find schools in a particular area, visit the Schools Online website. The My School website also enables you to search the profiles of almost 10,000 Australian schools. Information on the site has been provided by individual schools and education authorities.
For more information about primary schools and to find schools in a particular area,
visit the Department of Education and Early Childhood Development website.
Further information
Association of Independent Schools of Victoria website
Catholic Education Office website
www.liveinvictoria.vic.gov.au
For more details about the Program for Students with Disabilities (PSD) which provides additional sup-port for eligible students with disabilities in regular and specialist schools visit: www.education.vic.gov.au
The Handbook and Guidelines can also be downloaded from: www.education.vic.gov.au
Tips for Children starting school
- Clothes : It can be helpful to ask as early as July the year before about school clothing sizes (most schools start at size 6 and special orders for smaller sizes may need to be requested up to 8 weeks or more in advance!). If they do not make a smaller size dress then it may need to be custom made/modified. Larger sizes of jumpers/trackpants can sometimes be shrunk in hot water and tumbledried
- School bag: Ask what school bags they will be using – Spartans has a lighter and slightly smaller PhysioPak has extra padding and waist belt. visit http://www.spartanss.com.au/BackCare.html for more information. It is recommended that no more than 10% of a child’s body weight should be carried in a backpack (for some smaller prems this may be as little as 1.5 to 2kg.
- Lunch box: There is a range of lids that can allow independence. Some prems have decreased hand strength and dexterity so look for one that you child can open by themselves.
- Seating: Check if your child is able to place their feet on the ground when sitting upright in their school chair. Flat feet on the ground helps with trunk stability allowing better writing, drawing, cut-ting etc… They may have smaller chairs or steps that your child can place under their feet.
- Communication: Don’t be afraid to talk to your child’s teacher about any concerns you may have with your child starting school. Your child’s teacher is probably more than willing to help with a smooth transition and assist with any additional needs and concerns.
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