The Turkish Journal of Pediatrics 2023 , Vol 65 , Num 2
Pediatricians` attitudes, practices, and perceived barriers to school readiness
Pelin Çelik 1-2 ,Tuba Çelen Yoldaş 3 ,Özge Balcı 4 ,Gizem Kara Elitok 5 ,Asena Ünal 6 ,İclal Ayrancı Sucaklı 2 ,Nihan Özel Erçel 7 ,Dilek Sarıcı 8 ,Tanju Çelik 9
1 Department of Pediatrics, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara
2 Department of Pediatrics, Division of Developmental Pediatrics, Ankara Bilkent City Hospital, Ankara
3 Department of Pediatrics, Division of Developmental Pediatrics, Gazi University Faculty of Medicine, Ankara
4 Department of Pediatrics, Division of Developmental Pediatrics, Ankara Training and Research Hospital, University of Health Sciences, Ankara
5 Department of Pediatrics, Şişli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, İstanbul
6 Department of Pediatrics, Adana City Hospital, Adana
7 Department of Biostatistics and Medical Informatics, Mersin University School of Medicine, Mersin
8 Department of Pediatrics, Division of Neonatology, Keçiören Training and Research Hospital, University of Health Sciences, Ankara
9 Department of Pediatrics, Dr. Behçet Uz Children’s Hospital, University of Health Sciences, İzmir, Türkiye
DOI : 10.24953/turkjped.2022.677 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.

Supplementary: Supplementary Appendix

Keywords : School readiness, pediatrician, adverse childhood experiences, developmental surveillance, barriers
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