Head Start and Early Head Start health managers promote optimal health, wellness, and safety to help children get ready for school. They work with staff, families, and community partners to individualize health services. Health managers ensure children's nutrition, safety, and health, including physical, mental, and oral health, needs are met.

Section 642(e)(9) of the Improving Head Start For School Readiness Act of 2007 requires Head Start agencies to establish goals and measurable objectives for the provision of health, educational, nutritional, and social services. Goals must be related to the program mission and promote school readiness.

The Head Start Approach to School Readiness includes three major frameworks:

Together, they help health managers understand school readiness. Each framework supports individualizing health and disabilities services to meet the needs of all children and families.

Steps to School Readiness

  1. Work with the School Readiness Team to Establish Goals for Improving School Readiness across Domains

    • Engage in program-wide conversations about goal development to ensure child health and safety is included. This can include specific discussions about the impact of health services such as lead levels, well-child visits and immunizations, and injury prevention on school readiness.
    • Include families and staff in goal development that integrates their health and safety priorities and reflects their home culture.
  2. Create and Implement an Action Plan for Achieving Established School Readiness Goals

    • Develop strategies that encompass physical, mental, and oral health, nutrition, and safety.
    • Consider ways to improve attendance and engagement in program activities.
    • Engage family and staff in planning health services activities that will be included in the school readiness goals.
  3. Assess Child Progress on an Ongoing Basis and Aggregate and Analyze Data Throughout the Year

    • Review health data alongside child assessment data to gather a complete picture of child assessment. Health data might include illness, injury, and nutrition data collected through health tracking.
    • Consider conducting child assessments in the child’s home language and at times when children are best able to demonstrate their skills and knowledge.
  4. Examine Data for Patterns of Progress for Groups of Children to Revise, Develop, and Implement Plans for Program Improvement

    • Use health data over time to understand how health impacts school readiness.
    • Plan health activities that promote child attendance and engagement in program activities.


Healthy Children Are Ready to Learn Health managers can explore this fact sheet for talking points about the connection between health and school readiness. It also explains how Head Start's management systems support comprehensive health services.

Health Services to Promote Attendance Program health managers and staff can help to ensure that children are more likely to regularly attend all program activities. Use this resource to develop and implement health policies and procedures that address prevention, early identification, and prompt treatment goals.

Screening for Social Emotional Concerns: Considerations in the Selection of Instruments [PDF, 7.1MB] offers practical information in a useful, concise format and provides references for validated assessment and intervention practices. The syntheses are produced and disseminated by the Office of Special Education Programs (OSEP) Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI).

When Health Affects Assessment provides questions to consider about the impact of child health on assessment. It also includes a list of tools that programs can use to improve child assessment strategies.

Making the Link Between Health and School Readiness helps health managers as they link school readiness goals and health services strategies. Managers can use this tool to understand the research connections, develop talking points about health and school readiness, and find strategies to support school readiness goals for health services and school readiness plans.

Data in Head Start and Early Head Start: Digging Into Data offers health manager opportunities to practice the four basic steps to integrate data into planning, implementing, and evaluating health services. Using data, health managers can determine whether their services help children meet school readiness goals.

Stories from the Field

Health Managers. HHS/ACF/OHS/SR. 2014. English.

Last Reviewed: June 2014

Last Updated: January 14, 2015