Fit for School, Fit for Life

Fit for school, fit for life: Child health and school readiness

Dr. Catherine Birken, Hospital for Sick Children




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 on school readiness and achievement. School readiness is an important outcome of health and development in early childhood.  Differences in children’s first years of school may be related to later academic and career success. 


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.


Objectives and Study Procedure


The objectives of this longitudinal observational 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.


Importance of the Study


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


  • Will my child need to do any extra work at school?

    • No, the EDI requires the teacher to complete a checklist survey of children’s activities and readiness to learn at school.  It takes teachers approximately 7-20 minutes to complete, and can be done electronically in some cases.


  • Will this affect my child’s school reports or evaluations?

    • No, the EDI is not related to the teacher’s reporting of your child’s progress at school.  Results are not placed in students’ OSRs.


  • What if my child’s teacher doesn’t have time to fill out the EDI form?

    • Participation is voluntary.  Your child’s teacher will receive an email regarding the project, but may decide not to participate if they are unable to or don’t wish to do so.


  • Will I be informed of my child’s score on the EDI?

    • The EDI has been used to assess school readiness in groups of children.  We don’t yet know the meaning of an individual child’s EDI score.  We won’t return results of individual scores to parents.  School report cards and interviews with your child’s teacher provide more detailed and specific information about your child’s progress at school than EDI scores do.  Teachers inform parents about children’s school performance, and will address any concerns through the regular school reporting process.  Parents may wish to print off a copy of the questionnaire from the EDI website ( and make an appointment with their child's teacher to go through the form, or answer any questions during the school year, if they have any concerns.


  • Will we get the test or study results?

    • Once we have study results to share with you, they will be posted on our website, at  We anticipate that data collection will be complete in 2019.