Child, Preschool

What Parents Need to Know About Kindergarten Readiness

Author/s: 
Clare C. Crosh, Katherine A. Poehling, Lindsay A. Thompson

Kindergarten readiness is when a child begins school prepared and ready to learn. It involves much more than knowing letters or numbers. Kindergarten readiness includes basic social skills, like taking turns and sitting still to hear a story. It also includes a child’s ability to manage their emotions and understand early learning concepts like letters, numbers, and shapes. Expectations for kindergarten readiness can vary. Your child may complete an assessment before or at the start of kindergarten to help teachers understand their development across different areas. These assessments help guide instruction to the strengths and opportunities for growth for the children in that class.

Families, schools, and communities all play a role in a child reaching these milestones. Schools work to meet children where they are. Communities provide safe environments and places to support early learning. Your local public library is a great resource when it comes to your child’s early development.

Importantly, parents and caregivers serve as their child’s first teacher. The first 5 years of life are a time of rapid brain development. Daily interactions shape learning and development of skills needed for kindergarten readiness. The following are examples of ways to prepare your child for kindergarten throughout their first 5 years of life. Read together to build language skills and strengthen your relationship. Do puzzles and play with building toys, like blocks, to support spatial skills and problem-solving. Encourage coloring and drawing to build creativity and motor skills needed for writing. Tell stories and invite your child to help create or act them out to build creativity, language, and social-emotional skills. Play with your child and let them choose what and how to play, which builds confidence, independence, and decision-making skills. Keep regular routines for sleep, meals, and daily activities to give a sense of stability and support learning. Encourage your child to independently perform self-care skills, such as dressing, bathroom skills, and cough etiquette. Limit screen time to no more than 2 hours a day to enable a child to build social skills and learn from real-life interactions.

Your child’s abilities to manage their emotions and build positive relationships with classmates are key skills for success in kindergarten. Emotional regulation can often be harder to teach than letters and numbers. You can help build these skills in the following ways:

Talk about your own feelings with your child and why you feel that way.

Model calm behavior and help your child name their emotions.

Praise your child with positive words when they behave well to encourage good choices.

Teach your child calming techniques, like deep belly breathing or counting as you breathe in for 3 seconds and out for 2 seconds.

Each child develops at their own pace. A wide range of developmental skills is typical. If you have concerns about your child’s readiness, you can talk with your pediatrician. Remember, as your child’s first teacher, you play a key role in helping them prepare for a successful start to kindergarten.

Effect of an Intranasal Corticosteroid on Quality of Life and Local Microbiome in Young Children With Chronic Rhinosinusitis: A Randomized Clinical Trial

Author/s: 
Latek, M., Lacwik, P., Molinska, K., Blauz, A., Lach, J., Rychlik, B., Strapagiel, D., Majak, J., Czech, D., Seweryn, M., Kuna, P., Palczynski, C., Majak, P.

Importance: Intranasal corticosteroids (INCs) remain the first-line treatment of chronic rhinosinusitis (CRS) in both adults and children, despite the lack of evidence regarding their efficacy in the pediatric population. Similarly, their effect on the sinonasal microbiome has not been well documented.

Objective: To assess the clinical, immunological, and microbiological effects of 12 weeks of an INC in young children with CRS.

Design, setting, and participants: This open-label randomized clinical trial was performed in a pediatric allergy outpatient clinic in 2017 and 2018. Children aged 4 to 8 years with CRS diagnosed by a specialist were included. Data were analyzed from January 2022 to June 2022.

Interventions: Patients were randomized to receive intranasal mometasone in an atomizer for 12 weeks (1 application per nostril, once per day) and supplemental 3-mL sodium chloride (NaCl), 0.9%, solution in a nasal nebulizer once a day for 12 weeks (INC group) or 3-mL NaCl, 0.9%, solution in a nasal nebulizer once a day for 12 weeks (control group).

Main outcomes and measures: Measures taken both before and after treatment included the Sinus and Nasal Quality of Life Survey (SN-5), a nasopharynx swab for microbiome analysis by next-generation sequencing methods, and nasal mucosa sampling for occurrence of innate lymphoid cells (ILCs).

Results: Of the 66 children enrolled, 63 completed the study. The mean (SD) age of the cohort was 6.1 (1.3) years; 38 participants (60.3%) were male and 25 (39.7%) were female. The clinical improvement reflected by reduction in SN-5 score was significantly higher in the INC group compared with the control group (INC group score before and after treatment, 3.6 and 3.1, respectively; control group score before and after treatment, 3.4 and 3.8, respectively; mean between-group difference, -0.58; 95% CI, -1.31 to -0.19; P = .009). The INC group had a greater increase in nasopharyngeal microbiome richness and larger decrease in nasal ILC3 abundance compared with the control group. A significant interaction was observed between change in microbiome richness and the INC intervention on the prediction of significant clinical improvement (odds ratio, 1.09; 95% CI, 1.01-1.19; P = .03).

Conclusions and relevance: This randomized clinical trial demonstrated that treatment with an INC improved the quality of life of children with CRS and had a significant effect on increasing sinonasal biodiversity. Although further investigation is needed of the long-term efficacy and safety of INCs, these data may reinforce the recommendation of using INCs as a first-line treatment of CRS in children.

Trial registration: ClinicalTrials.gov Identifier: NCT03011632.

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