When a child turns two, parents are asked to complete a short questionnaire called the Ages and Stages Questionnaire, or ASQ-3. It asks about things the child can do – like whether they can kick a ball, follow simple instructions, or play alongside other children.
This questionnaire is not a test a child can pass or fail. It is a tool to help spot whether the child might benefit from any extra support early when it matters most.
A new joint Born in Bradford and University of York study tests, for the first time, if the use of the routine two-year developmental check (ASQ-3) can predict school readiness at age five. It found that children who showed signs of developmental delay at age two based on ASQ-3 review had three times the odds of struggling when they started school.
The study also confirmed significant and persistent inequalities. Boys were substantially less likely to meet expected development at both ages, while children growing up in the most deprived areas had 60% lower likelihood of being school-ready at five.
Children from South Asian backgrounds were least likely to meet expected milestones at age two, while White Other background kids were least likely to do so at five – a finding that underlines the need for targeted support across different communities.
Dr. Kate Mooney, Research Fellow at the University of York, highlighted:
These findings offer an important insight for the government’s goal to ensure 75% of children reach a Good Level of Development by 2028. The ASQ-3 can now more confidently be used to identify children who may benefit from accessing early years support, and this could support the prevention of inequalities in child development before children start school.
But the evidence also makes clear that the current system has gaps that cannot be ignored. For the ASQ-3 to fulfil its potential as an early identification tool, the government must act on several fronts, including supporting more families to be able to receive their two-year review and complete the questionnaire.
Prof Josie Dickerson, Lead Researcher at Born in Bradford said:
This research has direct implications for how local authorities design their Best Start plans, which are being developed now to meet the government’s 2028 school readiness target. Rather than waiting until children start school to identify those who need additional support, these findings suggest that improving how we deliver, and act upon, ASQ-3 reviews could help thousands of children to succeed in the future.
The research is published as a preprint and currently undergoing peer review. It is funded by the Wellcome Trust and the National Institute for Health and Care Research (NIHR) HDRC Bradford, followed thousands of children from their two-year ASQ-3 review to the end of their first year at school.