Boston Children’s Hospital’s Early Literacy Screening App can effectively screen for early signs of literacy challenges in only 30 minutes and link to risk-specific evidence-based responses to screening.

Project Overview

The Innovation & Digital Health Accelerator at Boston Children’s Hospital is developing an Early Literacy Screening App. The literacy assessments that the app will include were selected based on previous studies that examined early predictors of developmental dyslexia longitudinally in Dr. Nadine Gaab’s research. The app will be a cost-effective, mobile platform, accessible by parent, teacher, pediatrician or other clinical professional and capable of screening for early indicators of literacy challenges, including dyslexia, in children as young as four years of age giving them the opportunity to reach their full reading potential. The app will be presented in a fun, interactive way to keep the children engaged for the 30-minute screen. Once the screener is complete, parents will receive an overall score that measures the child’s risk for developmental literacy challenges along with essential deficit-specific risk resources.

The App will link to evidence-based responses to screening that offer teaching solutions and intervention programs (e.g. through instructional videos) for teachers, parents and social workers to address the instructional needs of children deemed at-risk. Furthermore, it will link to educational videos for parents that suggest activities that parents can do with their children that have been shown to improve these essential pre-reading skills.

Healthcare Context

Development of basic reading skills is one of the primary goals of elementary education. However 63% of fourth-graders are reading below grade level and about 80% of those from low socio-economic backgrounds1,2 Difficulty reading at grade-level can lead to low self-esteem, feelings of shame, inadequacy, helplessness and depression in children.3 Children with learning disabilities are less likely to complete high school or pursue higher education, and are at an increased risk of entering the juvenile justice system.4,5 The vast majority of working-age adults with learning disabilities – 92 percent – had annual incomes of less than $50,000 within eight years of leaving high school. Sixty-seven percent earned $25,000 or less.6

Additionally, a common literacy issue, dyslexia, is generally diagnosed after the most effective time for intervention has passed, which has been termed the ‘dyslexia paradox’. The ‘dyslexia paradox’ is detrimental to the well-being of children and their families who experience the psychosocial implications of dyslexia for years prior to diagnosis. Despite being diagnosed when a child fails to read (2nd – 4th grade), targeted interventions are most effective when administered in kindergarten and first grade. Dr. Nadine Gaab, of Boston Children’s Hospital, completed a recent study of more than 1,500 kindergartners in New England and identified six independent reading profiles, including three dyslexia risk profiles, and also showed that these reading profiles are remarkably stable over a two-year window – allowing it to be a predictive assessment for a future dyslexia diagnoses.


1.National Center for Education Statistics (2017). The Nation’s Report Card: A First Look: 2017 Mathematics and Reading.

2.Institute of Education Sciences, U.S. Department of Education, Washington, D.C.

3.Valas, H. (1999). Students with learning disabilities and low-achieving students: Peer acceptance, loneliness, self-esteem, and depression. Social psychology of education3(3), 173-192.

4.Mallett, Christopher A., “Disparate Juvenile Court Outcomes for Disabled Delinquent Youth: A Social Work Call to Action” (2009). Social Work Faculty Publications.

5.U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 4 parent interview and youth interview/survey, 2007

6.Cortiella, C., & Horowitz, S. H. (2014). The state of learning disabilities: Facts, trends and emerging issues. New York: National Center for Learning Disabilities, 2-45.

7.KPMG foundation Annual Report 2006

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