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Fit for School, Fit for Life

Fit for school, fit for life: Child health and school readiness
Dr. Catherine Birken, Hospital for Sick Children

What was the study about?

Childhood obesity and adult heart disease and diabetes have been identified as national health priorities.  We are learning that growth and weight changes in early childhood may impact school readiness and school achievement.  In addition, other child health factors such as physical activity, sleep, nutrition and development in early childhood may also impact school readiness and achievement. School readiness is an important outcome of health and development in early childhood.


In Canada, school readiness is assessed in Kindergarten using a reliable and valid tool called the Early Development Instrument (EDI).  The EDI uses information provided by Kindergarten teachers’ observations of children in their classrooms in five domains:  physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge.  The EDI is used to report on groups of children in different communities.  It is not used to assess children individually, or for making a clinical diagnosis such as a learning disability.


There are critical gaps in knowledge about how child growth, health and development in the early years influence school readiness.  By linking data collected through TARGet Kids! with information provided by the EDI, this important study aims to address those gaps.

What was the study's goal?

The objectives of this long-term study are to determine if growth trajectories in early childhood (age 0-3 years) are associated with school readiness (at age 4-5), as measured by the EDI. We will also determine if physical activity, sleep duration, nutritional factors, and development are associated with school readiness, using the EDI.  We will ask teachers of children enrolled in TARGet Kids! to complete the EDI when children are in Junior and Senior Kindergarten.

Teaching sitting children

Why was the study important?

Evidence generated from this study will contribute to primary care screening interventions for growth and development, and identify new targets for promoting school readiness. This evidence as a whole can be used to identify, implement, and evaluate early interventions aimed at promoting school readiness in young children in Canada.

More information about school readiness and the Early Development Instrument (EDI) can be found at


Frequently Asked Questions

  • What is informed consent?
    Informed consent is where you are given all the necessary information about a study so you can make a knowledgeable/informed decision to take part or not. Click here for information about informed consent.
  • What are the criteria for enroling in TARGet Kids!?
    TARGet Kids! recruits families with children under 6 years of age who are healthy as reported by their parents. Children with asthma are eligible for the project as well.
  • My child suffers from a chronic condition. Can he/she still participate?
    If the chronic condition does not interfere with your child’s growth and development (e.g. asthma), they may participate.
  • My child was born prematurely. Can he/she still participate?
  • How long are you planning on running this study? Until what age will my child be followed?
    While TARGet Kids! has no official end date, we are aiming to follow-up children as long as they are attending their annual check-ups with their current physician and until they are adolescents.
  • How long do I have to participate?
    You and your children can participate for as long as you want to and are interested.
  • How many children are in the study so far?
    There over 11,000 participants enroled in TARGet Kids! so far. This is now the largest study of young Canadian children recruited through doctors’ offices.
  • Is all the information confidential?
    Yes, all the information collected for TARGet Kids! is kept confidential. Any information that can identify you or your child (names, birth dates, addresses) are kept separate from the forms and both are kept in locked filing cabinets in a locked office. Our data is managed and analyzed at the Applied Health Research Centre (AHRC) which is a full service, academic, clinical research coordination centre. Policies and procedures regarding the conduct of research are governed by the Government of Canada Panel on Research Ethics.
  • Is my physician part of the research team?
    If your physician is at one of our participating clinics and has agreed to participate in TARGet Kids!, then they are a part of the research team.
  • Can you explain more about the blood sample that will be taken?
    Blood samples will be taken by research assistants trained in taking blood from children. About 9-12 ml (less than 1 tablespoon) of blood will be taken. This is well within the acceptable amount for research purposes in this age group. The whole procedure usually takes about 5 minutes. The blood will be transported and processed at Mount Sinai Services which provides state-of-the art laboratory services to researchers. Your child’s blood may be tested for iron, glucose, calcium, liver enzymes, among other things.
  • Will my child have blood taken at every visit?
    No. Depending on your child's age, a blood sample may not be taken at a particular visit.
  • Will I get the blood work results?
    All blood work results are sent directly to your child’s doctor for review. Parents will be contacted immediately if any results are out of normal range. If the blood work comes back normal, parents will not be contacted.
  • Do we have to go to SickKids or elsewhere for the blood work or the follow ups?
    No. All blood work and follow ups will occur at your child’s doctor's office during regularly scheduled visits.
  • Is there anything I can apply for my child before blood work to ease the pain?
    Topical anesthetic cream (EMLA or Ametop) is offered to minimize discomfort from blood collection.
  • How long does it take to fill out the questionnaires?
    The length of the questionnaires depends on your child’s age at the time of their visit and might take up to 45 minutes to complete.
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