Health & Fitness

Medical professionals’ advice to parents when choosing a preschool

Jay'len Richardson, 5, raises his hand in class at Liberty Academy, April 19, 2016. The school is a preschool that offers high-quality care for students living in a challenged neighborhood.
Jay'len Richardson, 5, raises his hand in class at Liberty Academy, April 19, 2016. The school is a preschool that offers high-quality care for students living in a challenged neighborhood. Miami Herald File

Choosing the right preschool can be an overwhelming task. It is a great responsibility asking another person to care for your young child. Do you know the right criteria for choosing a school? Or are you focusing too much on the academics and not enough on the overall experience your child will have?

In the United States, we've decided that increasing academic demands on young children is a good thing. What we haven't considered are the potential negative effects.

Research tells us that children’s healthy development is dependent on positive and safe experiences throughout the early years of life. Recent research also has identified a possible correlation between attention-deficit/hyperactivity disorder (ADHD) and increasing academic demands on young children.

When University of Miami Health System physicians studied educational and public policy literature that documented time children spent on academic activities, we were alarmed to find how much education had changed since the 1970s. From time spent studying to enrollment rates in pre-primary programs, everything had increased, and not surprisingly, in the past 40 years we also saw ADHD diagnoses double.

From 1981 to 1997, time spent teaching 3- to 5-year-olds letters and numbers increased 30 percent. We also discovered that the percentage of young children enrolled in full-day programs increased from 17 percent in 1970 to 58 percent in the mid-2000s.

While ADHD is a neurobiological condition, it is influenced by age-dependent behaviors and demands of the environment. In the coming weeks, as you do your research and make school visits, remember these factors when considering a preschool to protect your child’s health while enhancing their education:

Accreditation and credentials: Look for a preschool that is accredited, having gone through a voluntary process to ensure they meet certain academic, social and quality standards. The largest accrediting organization for preschool programs is the National Association for the Education of Young Children (NAEYC), and Quality Counts is another voluntary rating system. School directors should have a degree or background in education or early child development. Teachers should be trained in classroom management, effective discipline, child development and CPR.

Physical environment: The safety and cleanliness of the school is important. Look for outer doors that require a unique parent code to unlock the door or locked doors that need permission to enter the preschool. There should be a front desk area with an inner door or barrier separating this area from the classrooms. Check the playground to make sure it’s secure and the equipment is safe. There should also be separate areas for younger and older children to play. If not, are there different times that the younger and older children use the playground?

The classroom should have a mix of open space to play and enough seating for each child. Look for different play areas, such as an imaginative play area, science area, reading area and building or block area. A visible schedule and a set of class rules, including three to five positive expectations for your child's behavior, should be posted. Expect plenty of the children’s work displayed on the walls.

Student-to-teacher ratios: For your child’s safety and education, there are expected teacher-to-student ratios.

▪ For children under 12 months, there should be one teacher for every four children.

▪ 12 to 23 months, one teacher for every six children.

▪ 24 to 35 months, one teacher for 11 students.

▪ 36 to 47 months, one teacher for 15 students.

▪ 48 to 59 months, one teacher for 20 students.

▪ 5 and older, one teacher for 25 students.

Curriculum: Children learn through different means, including experience and visual, verbal and auditory senses. Look for teachers who use fewer handouts and teach lessons through a variety of immersive activities. Avoid preschools that are teaching above the developmental level of your child, and whose lessons or activities are too long. Activities should not last longer than 20 minutes.

Emotional development: What is most important is the focus on social, emotional development. This is a time where children learn to share, use their words, problem solve and regulate their emotions. Look for supportive teachers who can help guide your child in acquiring these basic skills. Children who have these skills have better outcomes in kindergarten and long-term academic success.

Choosing the right preschool for your child is a difficult decision. Find a place where the children are happy and there is low teacher turnover. Pick a center that matches your values. Finally, trust your instincts, and give your child at least four to six weeks to get used to their new school. After an initial adjustment period, your child will thrive.

Tatiana Hidalgo, Psy.D., and Ruby Natale, Ph.D., Psy.D., are early intervention researchers, and Jeffrey Brosco, M.D., Ph.D., is the associate director of the Mailman Center for Child Development at the University of Miami Health System. For more information, visit