Early Literacy Research Library (ELRL) - Article

From Descriptive to Predictive: Linking Early Childhood Developmental and Behavioral Screening Results with Educational Outcomes in Kindergarten

Schlichting, L.E., Vivier, P.M., Berger, B., Parrillo, D., Sheldrick, R.C. (2022) From Descriptive to Predictive: Linking Early Childhood Developmental and Behavioral Screening Results With Educational Outcomes in Kindergarten, Academic Pediatrics, In press. ,

Access: Institutional Access

Publication year


study description

Data Linkage

core topic(s)

Pediatric Primary Care

Population Characteristics

Kindergarten , Toddler/Preschool

Exposures, Outcomes, Other

Child Development (general) , Language and Literacy Development , School Readiness and Educational Outcomes , Screening and Tools


To assess the predictive value of a pediatric screening tool by linking two independent databases: an educational database that includes data from standardized academic assessments administered during kindergarten and a pediatric database that includes screening results.


Survey of Well-being of Young Children

outcomes evaluated

STAR Early Literacy Exam


Kindergarten STAR Early Literacy examination data from 2015-2019 for the Providence Public School District (PPSD) in Providence, Rhode Island were obtained.


A database that includes results of the Survey of Well-being of Young Children (SWYC) completed during pediatric visits were linked to an educational database that includes STAR Early Literacy examinations in kindergarten. Linear multilevel regression modeling was used to examine if screening results on the developmental and behavioral sections of the most recently completed SWYC form predicted trends in the percentile rank on the STAR exam over the school year, adjusting for potential confounders.

sample size

n=586 (children)


STAR Early Literacy Exam: assesses foundational reading skills including phonological awareness, phonics and word recognition, print concepts, and fluency, as well as numbers and operations skills such as counting and cardinality, operations and algebraic thinking, and measurement and data.
SWYC Forms: 10 questions regarding motor, language, and social cognitive development. The Preschool Pediatric Symptom Checklist (PPSC) on the SWYC contains 18 questions that assess a child’s emotional and behavioral development.
Measure of Child Characteristics: Child characteristics, including age, sex, race/ethnicity, and participation in the National School Lunch Program, were examined using demographic data from the Rhode Island Department of Education.


Linking the two databases resulted in a sample of 586 children who were administered at least one SWYC evaluation between 24-48 months and completed at least one STAR Early Literacy examination in kindergarten. The sample represents a diverse population with 55% Hispanic children, 25% Non-Hispanic black children, and 91% of children receiving a subsidized lunch. After adjusting for confounders, children with a positive developmental or behavioral screen had significantly lower percentile ranks on the STAR exam.


Early developmental and behavioral screening results predicted performance on the STAR exam in kindergarten. Children with developmental and behavioral concerns may be less ready to enter kindergarten than peers without such concerns. These preliminary findings provide proof-of-principle of the potential utility of developmental screening tools in identifying children with reduced school readiness who may benefit from intervention prior to kindergarten.


First, our study is limited to a single school district in RI, and while its diverse sample may contain children who are at risk for deficiencies in school readiness, it is not representative of all school districts. Furthermore, the SWYC was not administered in RI until 2014 and many of the children who have received a SWYC screen have not yet reached kindergarten age in the cohort of children who have completed a STAR assessment, resulting in a moderate sample size. In addition, the sample is imperfect in that we used the most recently completed SWYC developmental and behavioral sections in our modeling to provide the largest sample size available to us; different age-specific forms may have different predictive value. We also do not have any information on clinical interventions offered as a result of the SWYC screening scores, although we note that early intervention is likely to attenuate associations. Lastly, the STAR Early Literacy exam does not provide separate assessments of literacy and numeracy. Developmental and behavioral challenges may have different impacts on these two different types of skills.