In the past year, Christian King, a doula based in Kansas City, has supported more than 40 mothers enrolled in Medicaid through their pregnancy, birth and postpartum.

In that role, she helps educate and support families about birth and babies, but her work also takes on a more nontraditional approach.

When one mother’s water was shut off at four weeks postpartum, King helped her find reconciliation services to turn the utilities back on. When another mom couldn’t afford car repairs, King found an organization in Raytown that provided financial assistance. She helped one client secure a car seat from the local health department and another fill her closet with baby clothes.

King, 35, hopes that soon, “just like going to the dentist and going to the eye doctor, obtaining a doula and having a doula present is also one of those things that you just have to have on your team as part of services for maternity.”

Doulas do not deliver babies. They advocate for the physical and mental wellbeing of mothers and their families.

For the past 15 months in Missouri, anyone enrolled in Medicaid while pregnant and postpartum can have a doula by their side for free. Now, a group of bipartisan lawmakers are hoping to expand the program in an effort to continue combating the state’s poor infant and maternal outcomes.

“The statistics tell a devastating story of the lives lost that could’ve been saved if we put in the proper measures,” said state Sen. Barbara Washington, a Democrat from Kansas City who proposed one iteration of the . “There are third-world countries that have better maternal mortality rates than we do.”

The bill is estimated to cost around $300,000. While substantial amid a predicted state budget shortfall, state Rep. also filed legislation to expand the program, said she believes the long-term savings of having fewer Missourians who require medical attention will make up for the cost.

On average, 70 women die each year in Missouri during childbirth or in the first year postpartum. Of those deaths,

In Missouri, than women on private insurance, according to a 2024 report published by the state’s Pregnancy-Associated Mortality Review that looked at women who gave birth between 2017 and 2021.  A 2023 and also pointed to doulas as a solution.

In fall 2024, the Missouri Department of Social Services issued an , citing “an immediate danger to the public health, safety or welfare of pregnant women in Missouri.”

Since the program’s inception, there have been about 625 participants insured through Medicaid who accessed doulas during their pregnancy and postpartum, said Baylee Watts, a spokeswoman for the Department of Social Services. As of this month, 108 doulas were enrolled in the program.

“The department is encouraged by the level of engagement so far,” Watts said in a statement. “And views the doula benefit as an important component of broader efforts to improve maternal health outcomes across Missouri.”

Legislation filed by state Rep. Tara Peters, a Rolla Republican, has moved the farthest this year, clearing committee in February as part of a  Her bill seeks to increase the number of covered doula visits from six to 16.

The average out-of-pocket cost for a doula in Missouri is about $1,500, according to the Missouri Doula Association.

“I’ve just noticed how much extra care a doula can provide, especially for women in high need situations,” said “Doulas can provide some great education and support for people who maybe don’t have the extra support.”

This support can also look like serving as an interpreter between medical professionals and pregnant people, navigating insurance, ensuring access to nutritious food or coordinating transportation to medical appointments.

, who previously served as executive director of Monarch Family Resource Center in Farmington, said expanding the number of covered visits can be particularly helpful for women who experience postpartum depression in the year after giving birth.

Her legislation, like Peters’, expands the number of reimbursable visits from six to sixteen, and includes access to doulas for prenatal, birth, postpartum and lactation support.

She said the legislation also hopes to correct some issues doulas have had getting full reimbursement after being in the room for a scheduled c-section, listed as a scheduled surgeries, a classification she said muddled the reimbursement process.

The Department of Social Services previously said the reimbursements could lead to savings for the state in the coming years, including by potentially reducing the Cesarean rate. Watts said it’s too early to get an accurate look at this result.

said doulas can be a lifesaving set of eyes and ears in homes where women experience domestic violence, a leading cause of pregnancy-associated deaths in Missouri.

“The doula birth worker can also have a voice in those situations and see what’s going on outside of that medical office,” she said. “And maybe be able to provide some rescuing relief from dangerous situations for mom.”

To be eligible, and certified through a national or Missouri-based doula training organization. From there, they will be added to a list of eligible doulas overseen by .

Sandra Thornhill, a social justice doula who has advocated in Jefferson City for better legislation for doulas, said it was beautiful to see this policy issue reach across the aisle. And she was happy to see some of the proposals pushing for increased visits, especially in postpartum.

She said it’s not a question of if doulas should be reimbursed, but of how the state honors the traditional practices and values of doulas in that process. She is wary of any policies that place community health workers under medical or state authority. Instead she hopes to see more collaborative models.

”My concern is not with recognizing doulas in the Medicaid policy, but with how the bill structures authority and governance over that work,” said Thornill, who describes herself as a womb warrior and policy griot. “The question is whether the policy structure strengthens community birth workers or will it place unnecessary burden or medical authority that doesn’t reflect the roots of the work.”

But she said the progress made in acknowledging and supporting doula’s work in the past few years is striking, especially as many doulas live “birth to birth” as they struggle to pay the bills.

Prior to the state’s Medicaid reimbursement plan, to help families in need for free as they navigated growing their families.

“They do it because they love their people and their community so much that they’re willing to make this great sacrifice,” Thornhill said. “
However, it is not healthy. And it is not fair for the community to have to suffer like that when there are resources available to change that. But again, those resources cannot come with a slap on the wrist. They cannot come with a backlash of ‘now you’re under our thumb.’”

A representative with America’s Health Insurance Plans voiced opposition to Washington’s bill in a committee hearing last month.

“We are very concerned about issues with education, standardization and making sure doulas are all on the same page and we know exactly how they’ve been trained,” he said. “There seems to be some resistance out there and a lot of independence within the organizations.”

Washington’s legislation also seeks to ensure health benefit plans offer coverage for midwifery services. She said this is especially crucial in rural parts of the state, where families don’t have access to nearby hospitals with maternity wards.

“Currently, our law does not explicitly require private health plans to cover midwifery. This would close that loophole,” Washington said, adding that this change would shift power back to patients to choose their own provider, especially in rural communities “where the hospitals are closing at alarming rates.”

is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.

The books she read in school didn’t interest her and “constant deadlines made it even harder to connect with the stories,” she said. Reading was a chore, something to rush through for a test or school assignment. 

So when Wallace became a mother in 2019, she didn’t read to her son at home often – about once or twice a week, “maybe not even that,” said Wallace, who lives with her family in Frankfort, Kentucky.

That changed around the time her son was 3 and she was working at a local adult education center where she helped develop a family literacy program. There, she learned about on how reading to young children daily can improve school readiness, develop language and listening skills and promote social-emotional growth.

Now her family reads “three or four books every single night,” she said. 

The payoff has been clear: her son, Levi, has an impressive vocabulary for a soon-to-be 6 year old, can speak in complete sentences and most importantly “his confidence is boosting tremendously.”

“His life is going to be so much easier because he loves to read,” Wallace said. “I didn’t want him to grow up hating to read [like I did]. … I always struggled with comprehension and remembering what I read, and so it’s challenging when you don’t love doing it.”

Wallace’s initial resistance toward reading may be the new norm among parents. Earlier this year, HarperCollins UK showing a steep decline in the number of caregivers who read to their young children.

For many new parents, a dislike of reading stems from their own classroom experiences in the early 2000s that emphasized reading as a skill for testing. Many also are unfamiliar with the importance of reading to young children or may instead undervalue reading because of a dependence on online educational programs that have limited benefits for learning. 

For children not getting the benefits of being read to at home, the opportunity gap has widened, with those young students entering school unprepared compared to those who have been read to.

“The gap really begins very, very early on. I think we underestimate how large a gap we’re already seeing in kindergarten,” said Susan Neuman, professor of childhood and literacy education at New York University, adding she recently visited a New York City kindergarten classroom and saw some children who only knew two letters compared to others who were prepared to read phrases. 

A found a 5-year-old child who is read to daily would be exposed to nearly 300,000 more words than one who isn’t read to regularly.

The 2025 HarperCollins survey found less than half, around 41%, of children between the age of zero to four were read to every day or nearly every day; a decline of nine percentage points from 2019 and 15 percentage points in 2012. 

The survey found that about a third of parents read to their babies and toddlers weekly. Around 20% of parents said they “rarely” or “never” read to their child between the ages of zero and two and 8% of parents said they “rarely” or “never” read to their child between the ages of three and four.

It’s something that doesn’t surprise early literacy experts in the United States who suspect similar trends across the country, believing the decline in early literacy reading is likely even higher than reported.

“Frankly, parents … will often lie because they know it’s important to read, so they’ll exaggerate the amount of time they’re reading,” Neuman said. “I think the bottom line is reading is declining big time, not just for parents reading to children, but for all segments of our society.”

But, some of the youngest parents, those born between 1997 and 2012 – also known as Gen-Z – are more likely than past generations to view reading as a school or work activity rather than fun or beneficial, according to the HarperCollins survey and early literacy experts. 

For many young adults, their experience in the classroom, especially during the peak of the No Child Left Behind Act, which mandated annual standardized testing in the early 2000s, took the pleasure out of reading and instead instilled a shift toward “skill and drill,” practices, said Theresa Bouley, an education professor at Eastern Connecticut State University.

“We went from fourth grade and sixth grade testing to every year – third, fourth, fifth, sixth, seventh, eighth,” Bouley said. “At that time we started using less books, more programs, more skill and drill and the purpose of reading only became learning different aspects of reading, like phonics or things like that, and not actually for purpose or pleasure or even having time to apply the skills they’re learning to actually read.”

An entire population of students may have lost the value of reading, and combined with being the first generation of digital natives, the United States’ youngest adults are among those who are now seeing some of the largest declines in literacy skills. 

And it’s likely they’re passing their habits down to their children, which can have crucial repercussions on the youngest emerging students’ skills.

“Children are not seeing their caregivers actually reading books and that sends a really strong message. … As a three year old boy, [they] want to do what dad’s doing,” Bouley said. “I think it’s equally important … [for a] child’s understanding of the purpose and joy of reading to see their parent reading.”

In Wallace’s case, she was able to make up for some lost time.

For other families, however, there isn’t a lot of opportunity to close the gap once a child enters school.

“There’s an assumption nowadays that when kids get to kindergarten, they need to know their letters and their numbers and this is highly predictive of whether or not they’ll be successful at the end of kindergarten and at the end of third grade,” Neuman said. “Teachers have a very short time to work on these kinds of things, and when children are that far behind, … I don’t see realistically that a teacher will be able to give the intensive support that children will need in order to catch up.”

Why does reading to our youngest children matter?

Early literacy researchers believe there’s a common misconception that reading to a child when they’re babies or young toddlers is useless because the child doesn’t understand what’s going on.

The activity however, “is a lot more than just reading and reading books,” Bouley said.

Reading aloud creates a foundation for literacy, she said.

Studies have shown it helps children develop communication and fine motor skills and also promote oral language skills, which are a strong predictor in future success in school. 

Books also open up a world of vocabulary that isn’t used in day-to-day language when parents speak to their children, Rebecca Parlakian, senior programs director at , an early childhood nonprofit, said.

“Shared reading does predict child vocabulary prior to school entry, and vocabulary predicts later emerging literacy skills. We also find that the quantity or frequency of parent-child book reading predicted children’s receptive vocabulary, which is the words they understand, their reading comprehension skills and their desire to read,” said Parlakian.

A study found that reading aloud to a child at eight months old was linked to language skills at 12 and 16 months, “so even infants being exposed to ongoing rich language made a difference,” Parlakian added.

And while “language and vocabulary are the primary benefits,” books also support “social-emotional skills because children are being exposed to the feelings and motivations of characters other than themselves,” Parlakian said. 

‘Skill and drill’ 

Reading aloud is also beneficial for children to develop a positive association with the activity.

“There’s a lot of warm fuzziness and social emotional development that goes on. So now in kindergarten, if the teacher whips out a book, I remember my dad read me that book,” Bouley said.

Having a positive association with books, without the pressure of assessments or skill tests, allows young children to understand the value and fun of reading. 

“It builds connections,” said Carol Anne St. George, a literacy professor at the University of Rochester. “People talk about text to text, text to world … and those are the kinds of things that help children cognitively think and classify their world around them.”

But, it’s becoming a lost art.

Instead, reading in schools has become performance-based activity or test preparation.

“Whether it’s parents at home and also teachers in schools, we’re seeing so few books, and so few opportunities for children to read – really read,” Bouley said.

There’s a pressure in the United States to “press reading very very early,” Neuman added. 

“If we look globally at other cultures where children are more successful, , … they don’t start formally reading with children with the expectation they should read by third grade. They recognize that play is really important in these early years, that talk and oral language is extremely important, and they focus on other things,” Neuman said. “But, we’re in a race.”

That “race” has contributed to changes in curriculum and a pullback on activities like read alouds in the classroom, which Bouley, Neuman and St. George said they’ve all seen. 

“I don’t see that time really devoted and yet that’s so critical,” Neuman said. “The language that they’re getting through that storybook and experience is really imperative. I don’t see it as much. I see a lot of skill and drill.”

Among some researchers, there’s a belief the shift happened around 2002 as the United States shifted toward an annual testing model. 

“We became inundated with assessments and preparation,” Bouley said. “So first graders, second graders, they’re constantly getting these assessments that definitely take the purpose away from reading for enjoyment to reading as skill.”

Timed reading fluency assessments, for example, “just shows kids that you can’t go back and read accurately,” and “all that matters is how many words you can read in one minute,” Bouley added. 

“So children get these messages about all that matters with reading and none of it has to do with comprehending a book and enjoying a book,” Bouley said. “It got much worse, or even started after No Child Left Behind, and then it’s just become worse and worse.”

Many of those former students are now parents, like Wallace, who may struggle with passing on literacy skills because of their own experiences in the classroom. 

From one technology-raised generation to the next 

Reading for pleasure in the United States has between 2003 and 2023, according to a 2025 study from the University of Florida and University College London.

The same study said it’s unclear whether levels of reading with children has changed over time, but it did find only 2% of its participants read with children “on the average day,” despite 21% of the study’s sample having a child under nine years old.

Declining literacy levels also go hand-in-hand with the rise of the internet and accessibility to portable devices. 

“This is a generation where we really begin to see a drop in reading for pleasure because they were part of that initial wave and flood of digital media that was totally unregulated. We had no research on the impact,” said Parlakian. 

Those patterns from the first generation of digital natives are now being mirrored to another generation of children.

A from the PNC foundation reported about 35% of parents said some of the biggest challenges in reading to children is that the child prefers screen-time or won’t sit long enough. 

“When we introduce screen time very young, and we don’t manage the amount of time children are spending on screens, … it can be difficult for children to transition from such an exciting medium to a medium like a book that may initially feel not as exciting,” Parlakian said.

While some parents may argue their young children may not have to read as much with physical books because they’re instead benefiting from educational programs on tablets or phones, early literacy experts said there’s a difference between the two activities, both social-emotionally and academically.

A lack of reading time with a parent possibly means losing bonding time. With a tablet, a parent can hand it off and walk away, Bouley said, but when it comes to reading a book, it demands a parent’s full presence.

Skills wise, until around the ages of 5 and 6, children have a “really hard time and are incredibly inefficient at transferring learning that happens on a screen to real life,” and vice versa, Parlakian said.

Reading also requires stamina — and educational programs on tablets or other devices, instead offer instant gratification, Neuman added. 

“A good storybook often takes a bit of time to develop. … There’s literary language that children are learning, … and games are very colloquial, they’re very short term and they’re bits of information that don’t connect,” she said. “Children aren’t developing comprehension, … even when they begin to learn the print, what we’re seeing is they don’t know the meaning of the print, and that’s a big problem.”

Adopting early reading practices for the Wallace family means comprehension hasn’t been a problem for 5 year old Levi who points out the words he knows in his children’s Bible, or in his other favorites like Little Blue Truck or Brown Bear, Brown Bear, What Do You See?

“He can read almost a whole page by himself. He gets really excited and he has to go around and show his dad or we’ve got to FaceTime and show his mamaw,” Wallace said. “He wants everybody to see he knows how to read.”

Bill McCallum, a lead writer for the Common Core math standards, and Kristin Umland, then a faculty member at the University of New Mexico, led the effort, which was supposed to last a year or two. 

At first, Umland said, the organization was focused on helping other groups, including the and testing companies, improve their products to meet the more rigorous standards. 

Eventually, she said, the group shifted to creating the curriculum — including lesson plans — that it felt best served students as they strove to achieve both a conceptual understanding of math, the why of how math works, alongside procedural fluency, the ability to solve problems. 

Illustrative Mathematics now encompasses 90 employees — all are remote workers — with no central location. For those states that still use it, the curriculum is aligned to Common Core standards — and there are also state-specific versions for those states that don’t.

“Our goal is to change outcomes for students, regardless of the standards they are using,” Umland said. “Math is math, and all states agree that kids should learn math.”

Select schools within the New York City system have been using Illustrative Mathematics for half a decade. A recent, massive rollout across hundreds of campuses has been met with sharp criticism from many teachers and  

Some said the curriculum and for students to practice what they’ve learned. One educator acknowledged these initial growing pains but said , one that helped students more easily understand abstract concepts.  

Umland has heard all of the complaints. While she acknowledges these early days struggles,  it doesn’t mean the move is a failure. Only that it needs more time, she said. 

“There’s no magic bullet,” she said. “If there was, somebody would have figured it out by now.”

Los Angeles, which adopted the curriculum in its middle and high schools in 2023, meanwhile, .

����Ӱ�� talked with Umland recently about the math wars, how her organization’s approach stands out from the rest and about Illustrative Mathematics’s bumpy New York City rollout.

The interview has been edited for length and clarity.

Where does Illustrative Mathematics fit into the math wars? And by math wars, I mean that push and pull between teacher- and child-centered learning? 

We always see ourselves as a third way. There’s no-one-size-fits-all for all students in all contexts. There are times when students need to understand and hear a direct explanation. And there are other times they should be given a chance to think about it for themselves, make sense of it, grapple with it and discuss it. So, it’s not either or. It’s what’s appropriate for what you’re trying to help students learn in the particular moment.

What type of lesson would require a direct explanation? 

So, a perfect example is when kids are learning to count. There’s no way they can figure that out on their own. Numbers are different in different languages. That’s a completely cultural thing. That’s something you have to learn by hearing other people say the number to you. 

But when you’re starting to do addition, once they understand what three is and what two is, you can say, “If I have three marbles and two marbles, how many marbles do I have altogether?” 

The things that are cultural have to be taught directly. But once you understand what the meaning is, you can figure it out. 

How does Illustrative Mathematics’s approach to teaching and learning compare to most other curriculum methods?

A lot of folks learn mathematics from an “I do, we do, you do model,” where the teacher does an example question, then they work together with the students, and then the students go practice.

Our method sort of flips that model on its head, allowing students to think about a problem so they can get oriented to it. And then there’s discussion where they make sense of it. 

And, finally, the teacher brings it all together. It gives students a chance to think for themselves before being shown something. 

I can show you how to do two plus three by counting it all myself, or I can say, “Here’s a picture that shows two marbles and three marbles. How many marbles do you see altogether?”

Some kids will know how to count it and will do it. And some kids won’t. They’ll talk about it, share their strategies, and then the teacher can make sure that the student who does it correctly shows their solution. Or if none of the students do it, they can show them how.

Illustrative Mathematics had a rough rollout in New York City. What went wrong for some teachers/schools? 

A lot of the complaints weren’t necessarily about the curriculum itself, but about the rollout or the implementation. 

Teachers need to have professional development where they get oriented to the design structure and they get a chance to experience what a lesson feels like. They need a chance to practice.

Ideally, they have opportunities to collaborate with their colleagues on planning and they have coaching support as they go. It’s just sometimes hard to coordinate all of those pieces.

A lot of teachers, in the first couple of months, are still trying to understand how it works. But once they get to the second or third month, then they start to see how it works. When something is new, it’s harder. It doesn’t necessarily make sense. And it takes time for people to get oriented to it. 

We’re seeing the best success in the places where they’ve been doing it longer. They’ve put in a lot of time to support it and when they get to that phase, then they’re really seeing the outcomes for students.

What do you want to fix about mathematics education in this country?  

A lot of school districts have come to realize that they need high-quality instructional materials. They’ve made that commitment. Then they start to ask themselves, “OK, so what do we do for (struggling students)?”

In a multi-tiered system of support, tier one instruction is the core instruction that all students receive. Students identified as needing additional support will receive tier two instruction. Often, this means they will be pulled for small group instruction or additional instruction.

One of the problems is that for many of these students, it’s like they’re on a highway and then they get pulled off onto the frontage road — only they never find a way back. They end up on a parallel track. What we want is to figure out how to support these students.

How might you help kids stay on track? 

Right now, we’re really focusing on early math. We are currently developing a pre-K math curriculum. It will be available next school year. If you can get to students early, it has an exponential impact on them before they head on to later grades. If we can do a better job with the youngest math learners, they won’t have the problems that we see at the secondary level in the future. 

At first glance, play and explicit reading instruction can seem at odds. Under pressure to improve reading outcomes after years of falling or stagnant scores, schools might or limit imaginative activities to make time for instruction. But this is a false choice. shows that play is not only compatible with the science of reading — it’s a powerful way to build the very skills kids need to become strong readers in the first place. In fact, children learn best through hands-on, engaging activities that make new sounds and words stick.

That’s because play isn’t just fun; it’s serious learning. — where teachers set up fun activities with clear learning goals — is than direct instruction in promoting learning, particularly for young kids. For instance, that using activities like blocks, drawing and dramatic play to deliver literacy instruction improved children’s oral language, letter recognition and ability to sound out letter blends and words. Learning to read felt like a game for kids, but the gains were real. 

The Boston Public Schools’ evidence-based program shows how this can work at scale. There, children in pre-K through second grade spend most of the morning acting out stories, playing with letters and exploring books — all activities carefully set up by teachers to align with science of reading principles. Unlike many districts that have shifted instruction in the early grades to be more traditionally academic, Boston has made a play-based approach a focal point of K-2 learning. The results show it’s working: consistently display substantially stronger literacy and language skills than their peers who are not enrolled. 

In districts nationwide, programs like and go further. A Tools pre-K classroom, for example, uses themed dramatic play to teach early reading skills; in a pretend grocery store, children might create shopping lists (writing), sort items by categories (vocabulary) and engage in conversation with peers about what to cook for dinner (language development). Every Child Ready classrooms use songs, stories and games to teach sounds and letters, with teachers closely tracking progress to tailor instruction. These approaches combine the best of structured literacy and joyful learning to help children develop the skills to be . Studies show that kids in Every Child Ready on foundational literacy skills, while kindergartners in Tools of the Mind experience significant boosts in and . 

This combination of play and evidence-based reading instruction may be especially important for boys and children in schools serving primarily low-income students. As instruction has shifted toward more sit-still-and-listen activities, many boys — especially those who are among the youngest in their grade — . Play-based approaches, which offer more movement and choice, can help engage boys in learning early, laying a stronger foundation for reading and future academic success. 

For low-income children who are already to have access to for play than their wealthier peers, that minimal play time often gets sacrificed first as schools scramble to improve test scores. By making a shift away from play, schools could unintentionally be depriving kids of one of the most valuable and evidence-based tools in their toolkits. 

With below proficient in reading, addressing America’s literacy gap is critical. But the answer isn’t to turn early learning into a series of drills and worksheets. To inspire a joy for learning, play is key. Reading success should not — and doesn’t have to — come at the cost of the creativity, joy and social growth that are key to the early years. 

Education leaders and policymakers should promote evidence-based curricula, training and assessments that integrate both reading and play. Help teachers make literacy instruction playful and engaging, and give kids the freedom to imagine and explore as they learn, and you’ll see results. 

Disclosure: The Overdeck Family Foundation provides financial support to Tools of the Mind, Every Child Ready and ����Ӱ��.

In New York City, America’s largest school district, the birthday cut-off is even later: Dec. 31. One-third of children are . This is a cause of concern for many families.

The city Department of Education doesn’t see it as a problem. In an email, a spokesperson told me its official stance is, “We work to provide all families access to a world-class education, and we work closely with families to ensure students’ placements are academically and developmentally appropriate, in alignment with state guidelines. Our policies allow for flexibility, our kindergarten curriculum is responsive to the needs of our younger learners, and our dedicated educators are prepared to support every student.”

Not all are appeased.

“I have a 4-year-old who will start kindergarten this fall but doesn’t turn 5 until after Thanksgiving,” worried mom CK told me. “I think it’s a big disservice to these kids. The amount of sitting isn’t developmentally appropriate, and the lack of free play is concerning.”

Parents are justified in their concerns. As the summarized in June:

Several studies have concluded that kids who are youngest in their class are disproportionately diagnosed with ADHD. A Michigan study found that kindergartners who are the youngest in their grade are 60% more likely to be diagnosed with ADHD than the oldest in their grade. And it doesn’t affect just kindergarteners: A North Carolina study found that in fifth and eighth grade, the youngest children were almost twice as likely as the oldest to be prescribed medication for ADHD.

The research didn’t sit well with some teachers. One blasted my social media inquiry seeking views on redshirting by writing, “ADHD is a very serious IEP (Individualized Education Plan) and we don’t hand them out like candy.”

Others, however, agreed.

“My daughter was one of the youngest in her class,” wrote an anonymous mother. “The teacher and school counselor mislabeled her with psychological disorders that both NY special education testing and private neurological tests did not support.”

“More of my students with an IEP have a birthday in the second half of the calendar year,” confirmed Mary C., who has been a special ed teacher for 12 years. “I understand where an incoming K parent would be concerned that their December baby is much younger than a June baby.”

That was the case with Upper West Side parent KE’s son. “He is the youngest and smallest boy in the grade,” she wrote. “He started kindergarten at 4 years old, still sucking his thumb. The physical, emotional, social, psychological and other developmental differences between a 5-year-old born in January and a 4-year-old born in December impacts everything from holding a pencil to kicking a ball, to the length of time one can sit and concentrate. It was too early, too soon and too young, but we literally had no choice in the matter in order to enroll him.”

The problems that pop up with younger students can reverberate .

Pree Kaur lamented that her daughter “is always the younger one and is not as mentally developed as her peers, so she always feels as if something is wrong with her.”

The Riverdale dad of a son born in November wrote, “He had some difficulty following his teacher’s instructions in first grade, and his teacher repeatedly pointed out that he has difficulty sitting still, staying focused, etc. We had him evaluated by a pediatric developmental specialist and he was diagnosed with ADHD. I really struggle with the whole situation, as I believe if we were able to get him to go to school a year later, matters may have been different.”

“My daughter attended a citywide gifted program. She was doing great, but it came with a price,” confessed Annie Tate. “She was high-functioning until high school, where she was overwhelmed and was diagnosed with ADHD, a diagnosis I believe she wouldn’t have received if I didn’t send her to school at 4 years, 8 months. She would have matured emotionally and physically to be a healthier, happier child.”

Pediatric occupational therapist KJL sees this situation frequently: “Children with ADHD have a 30% delay in executive function compared to their peers. Combine that with young ages, and these children are set up to fail.”

When I posed the question of allowing parents to hold back their children on my , the most frequent response I received was, “SOMEONE has to be the youngest.”

That’s true. But the situation can still be ameliorated.

Grades with multiple classes can be broken up into three- or four-month bands, so students are learning with a narrower-aged peer group.

Repeating a year should be a more acceptable option, unlike the situation faced by mom Heather Hooks: “My son was very behind academically in first grade. The school refused to hold him back and cited studies on ‘retention’ being not good for kids in the long run. I found these didn’t take into consideration that this was not straight retention, but redshirting an ADHD kid. Other studies were significantly different, and suggested these kids have better outcomes and are less likely to be medicated.”

Another mom was told her daughter “wasn’t behind enough,” despite the child’s pleas that “it’s too much for my head.”

Any steps taken to help New York City’s youngest learners would provide the largest experimental sample size in the country, making those results potentially beneficial for students across America.

Based on what happens in NYC, the educational system can stop treating children as developmentally identical and schools as one-size-fits-all, giving families more options.

As Maureen Yusuf-Morales, who has worked at public, charter and independent schools, suggests, “Parents with children born after September should be allowed choice with guidance based on developmental milestones, as opposed to birthdays being the only hard-and-fast rule.”