Rapid declines in childhood literacy rates across the US prompt hospitals to screen for literacy

The rapid decline in childhood literacy across the United States has reached such catastrophic levels that Nationwide Children’s Hospital now screens children for basic reading skills starting at age three inside the doctor’s office. Pediatric teams in Columbus, Ohio, step in where the education system has already failed, catching problems early and giving parents concrete steps to intervene before kindergarten even begins.

Clinics were deliberately placed near the lowest-performing schools. In Columbus City Schools more than 63 percent of kindergartners entered the 2024-2025 year already behind in language and literacy. Nationally the numbers expose a deeper collapse: just over 30 percent of fourth graders read proficiently according to the 2024 National Assessment of Educational Progress.

That leaves roughly 70 percent of American children functionally illiterate and incompetent in reading after four full years of classroom instruction. Proficiency has dropped another four points since 2019.

Children who start kindergarten in the bottom 20 percent almost never climb out. Nearly three-fourths stay trapped in the lowest performance tier through fifth grade.

Since launching in 2022 the hospital has run more than 2,400 screenings, mainly for uninsured and Medicaid families. Literacy coordinators spend about ten minutes watching each child interact with a book, then hand over a personalized plan and a take-home kit containing books, dry-erase boards, safety scissors and pencils with grips. They model simple read-aloud sessions and remind parents they are the first teachers who must now compensate for years of systemic failure in the schools.

Coordinators follow up at the next visit, track progress and refer families to programs such as Head Start when gaps remain. In one documented case a three-year-old advanced dramatically in letter recognition and sight words within twelve months once home support began.

Medical offices are now forced to serve as emergency literacy checkpoints for an entire generation.