Routine questionnaire could help thousands of children thrive at school, study finds
Posted on Thursday 28 May 2026
For the first time, researchers from the University of York and the Born in Bradford project have evaluated whether the standard two-year health review - specifically the Ages and Stages Questionnaire (ASQ-3) - can predict a child's school readiness at age five.
The study found a strong link between early developmental delays and subsequent difficulties in the classroom.
The research team say the findings offer a practical framework for local authorities and policymakers working toward the government’s national target to ensure 75% of children achieve a ‘Good Level of Development’ by 2028.
Extra support
When a child turns two, parents are asked to complete the ASQ-3. It asks about things the child can do - like whether they can kick a ball, follow simple instructions, or identify everyday objects.
This questionnaire is a tool to help spot whether the child might benefit from any extra support early, when it matters most.
The study found that children who had a good level of development at age two on the ASQ-3 had more than three times the odds of being school ready 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.
Inequalities
Children from South Asian backgrounds were least likely to meet expected milestones at age two, while White Other background youngsters 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 Family Wellbeing Team, Public Health and Society Research Group at the University of York’s Department of Health Sciences, said: “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."
The study authors say 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.
Professor Josie Dickerson, Lead Researcher at Born in Bradford, added: “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 is currently undergoing peer review. It is funded by the Wellcome Trust and the National Institute for Health and Care Research (NIHR) HDRC Bradford, following thousands of children from their two-year ASQ-3 review to the end of their first year at school.
