University of York Research Reveals Potential of Routine Early Years Questionnaire

Researchers at the University of York have contributed to new evidence showing how a standard questionnaire used during routine health checks for two-year-olds could help identify children who may need additional support to succeed when they start school. The study, conducted in partnership with the Born in Bradford project, evaluated the Ages and Stages Questionnaire (ASQ-3) and its ability to predict school readiness at age five. Findings indicate a clear connection between developmental progress at two and later classroom outcomes, offering practical insights for early intervention strategies across the United Kingdom.

The ASQ-3 forms part of the standard two-year health review offered to families through the National Health Service. Parents complete questions about their child's abilities in areas such as communication, gross motor skills, fine motor skills, problem-solving, and personal-social development. Examples include whether a child can kick a ball, follow simple instructions, or recognise everyday objects. This tool has long served as an early screening mechanism, but the University of York analysis provides stronger validation of its predictive value for school readiness.

Context of Early Childhood Development in UK Policy

School readiness remains a key priority for the UK government, with a national target set for 75 percent of children to achieve a Good Level of Development by 2028. This benchmark encompasses personal, social and emotional development, communication and language, and physical development. Local authorities are currently developing Best Start plans to meet these objectives, and the research from York aligns directly with efforts to shift focus toward earlier identification rather than waiting until children enter primary school.

Early years support in the United Kingdom draws on a range of programmes, including health visiting services and integrated care pathways. The two-year review represents a critical touchpoint where developmental concerns can be flagged before formal schooling begins. By strengthening the use of existing tools like the ASQ-3, the study suggests opportunities to enhance prevention efforts and address disparities that emerge early in life.

Details of the University of York and Born in Bradford Study

The research followed thousands of children from their two-year ASQ-3 assessment through to the end of their first year at school. Led by academics in the University of York's Department of Health Sciences and collaborators at Born in Bradford, the study examined data from the well-established Born in Bradford birth cohort. This longitudinal approach allowed researchers to track real-world outcomes in a diverse urban population.

Dr Kate Mooney, Research Fellow at the Family Wellbeing Team within the Public Health and Society Research Group at the University of York, emphasised the practical applications. She noted that the ASQ-3 can now be used with greater confidence to identify children who may benefit from early years support. Professor Josie Dickerson, Lead Researcher at Born in Bradford, highlighted the direct relevance for local authority planning and the potential to help thousands of children achieve better outcomes.

The study appears as a preprint on medRxiv and is undergoing peer review. Funding came from the Wellcome Trust and the National Institute for Health and Care Research (NIHR) Health Determinants Research Collaboration Bradford.

Key Findings on Predictive Power

Children who demonstrated a good level of development on the ASQ-3 at age two showed more than three times the odds of being assessed as school-ready at age five. This association held after accounting for other factors, underscoring the questionnaire's value as an early indicator.

The analysis also confirmed that developmental trajectories established by age two often persist. Early delays in areas such as language or motor skills correlated with challenges in classroom settings, including difficulties with attention, social interaction, and learning engagement. These patterns support the case for targeted interventions during the preschool years.

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Addressing Inequalities in Child Development

The research uncovered significant and persistent disparities. Boys were substantially less likely to meet expected developmental milestones at both age two and age five. Children living in the most deprived areas faced a 60 percent lower likelihood of being school-ready at five compared with those in less deprived settings.

Ethnic background also played a role. Children from South Asian backgrounds showed the lowest rates of meeting expected milestones at age two, while those from White Other backgrounds were least likely to achieve school readiness at five. These findings point to the need for culturally sensitive approaches and tailored support that accounts for diverse community needs across the United Kingdom.

Implications for Universities and Research in Higher Education

This work exemplifies the growing contribution of UK universities to public health and education policy. The University of York's Department of Health Sciences has positioned itself as a leader in applied research that bridges academic inquiry with real-world impact. Such studies not only advance knowledge but also inform workforce development in early years education, public health, and related fields.

For academics and administrators, the findings reinforce the value of interdisciplinary collaboration between health sciences, education, and social policy departments. They also highlight opportunities for universities to engage with local authorities and NHS partners on translational research projects that address national priorities like school readiness.

Challenges in Implementation and System Gaps

While the ASQ-3 shows promise, the researchers identified barriers to maximising its potential. Not all families currently receive or complete the two-year review, limiting the reach of this screening tool. Improving uptake requires coordinated action from government, local authorities, and health services to ensure equitable access.

The study calls for enhanced support mechanisms once concerns are identified. Simply flagging issues is insufficient without corresponding investment in early intervention services, family support programmes, and community-based resources that can respond promptly during the critical preschool period.

Future Outlook and Policy Recommendations

The evidence positions the ASQ-3 as a valuable component within broader strategies to meet the 2028 school readiness target. Local authorities developing Best Start plans can incorporate these insights to prioritise early identification and reduce inequalities before children enter formal education.

Looking ahead, the research team advocates for continued evaluation of screening tools and greater integration of developmental data across health, education, and social care systems. This could lead to more seamless support pathways and better long-term outcomes for children across the United Kingdom.

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Role of Higher Education Institutions in Driving Change

Universities like York play a pivotal role in generating the evidence base that shapes national policy. Through rigorous longitudinal studies and partnerships with initiatives such as Born in Bradford, they provide the data and analysis needed for evidence-informed decision making. This model of engaged scholarship offers a template for other institutions seeking to contribute to societal challenges in education and child development.

Administrators and researchers in the higher education sector may find opportunities to expand similar work, particularly in areas with high deprivation or diverse populations. The findings also underscore the importance of training future professionals in early years settings to recognise and respond to developmental indicators identified through tools like the ASQ-3.

Broader Context of UK Early Years Research Landscape

The University of York study builds on a wider body of UK research into child development and school readiness. It complements efforts by organisations such as the Education Endowment Foundation and various NIHR-funded projects focused on early intervention. By focusing on an existing routine questionnaire, the work demonstrates how incremental improvements to established systems can yield significant benefits without requiring entirely new infrastructure.

Stakeholders across the education and health sectors have welcomed the emphasis on prevention. The research provides a timely contribution as policymakers refine strategies ahead of the 2028 deadline, offering a data-driven foundation for scaling effective practices.