Preschool should be for everyone

“The school keeps calling me to pick up my child.” “He got asked to leave because of behavioral issues.” These are common stories that we and many other pediatric providers caring for young children with developmental differences hear from families during their visit. Stories of children missing multiple days of school a week, students not having access to necessary sensory supports, parents being unable to work because they have nowhere for their child to go, and eventually stories of children being asked to leave one and often multiple early childhood education centers. These stories are consistent with data demonstrating that preschoolers are expelled at a high and disproportionate rate when compared to school age children in the United States (Gilliam, 2005). On a study of the National Survey of Children's Health there were approximately 50,000 children suspended and 17,000 children expelled at least once from preschool in the year 2016 alone. When focusing on preschoolers with autism spectrum disorder (ASD) in particular, these children are expelled at a 10 times higher rate than non‐ASD preschoolers at an average age of 3.3 years old (Novoa & Malik, 2018; Blacher & Eisenhower, 2023) In fact, the same study found that one out of every six children with ASD was expelled prior to entering kindergarten (Blacher & Eisenhower, 2023). These numbers are startling to see but mirror common stories that pediatricians and other providers caring for this patient population hear when speaking with families.