School readiness (SR) encompasses a wide range of skills that impact children’s ability to succeed in school and later in life1. Five recognized domains of SR include: Physical Well-Being and Motor Development; Social and Emotional Development; Approaches Toward Learning; Language Development; and Cognition and General Knowledge (including early literacy and math skills).2 Within the US, 30-50% of children enter kindergarten without the skills needed to be ready to learn, and children from economically disadvantaged households are at higher risk for poor SR.2, 3

Shared reading is an important strategy to assist children in becoming ready for school, and more frequent shared reading predicts a decreased risk of developmental, social, and behavioral delays in preschool-age children.4 Shared reading is an interactive process in which an adult and child look at and engage with a book together. Parent-child shared reading is pivotal to language development and emergent literacy.4, 5, 6, 7 Outside of language and literacy development, shared reading also benefits a child’s socio-emotional development and fosters a positive parent-child relationship.8, 9 Additionally, singing to an infant does have a positive impact on the infant’s language development10 and oral storytelling can increase a child’s story comprehension, word learning, and on-task behavior,11 important factors for SR.

Adverse childhood events (ACEs) impact a child’s life and long-term health outcomes, as well as negatively affect their ability to be prepared for school,12, 13 with research showing its effect on classroom behavior and literacy skills.14 An ACE is a traumatic event that occurs in childhood (0-17 years), and within the US, just under half of children have one ACE, while 10% have three or more ACEs.15 The chronic stress from exposure to ACEs can adversely affect a child’s socio-emotional, neurological, immunological, and hormonal development.16 Children exposed to ACEs have difficulties with self-regulation, math, and task engagement.13 ACEs may also have a dose-dependent impact on a child’s development, the higher the ACEs a child has the higher the risk of poorer health and developmental outcomes.17 The objective of this study was to assess if early literacy developmental activities were equally associated with improved SR among children with and without ACEs. Given the complex disadvantages children with ACEs may face in attaining SR, we hypothesized that early literacy developmental activities (i.e. shared reading, singing, or storytelling), would only be associated with improved SR among children with no exposures to ACEs.