Preschools Research Articles

El efecto de la pandemia sobre el desarrollo del lenguaje en los dos primeros años de vida

Background and objectivesThe effects that the COVID-19 pandemic may have had on the language development of children are still poorly understood. In this study, we examine the effect of the pandemic on this development by analyzing the vocabulary and the morphosyntactic level in a sample of toddlers. Participants and methodOne hundred and fifty-three boys and girls between 18 and 31months of age participated in the study. Of these participants, 82 were born and evaluated before the pandemic (PRE group) and the other 71 were born during the pandemic and were evaluated at the end of the 2021/2022 academic year, the last academic year in which restrictive measures derived from the pandemic were maintained in the schools (POST group). Both groups were matched by age and mother's educational level and attended nursery schools with similar socioeconomic characteristics. ResultsWe found lower scores both in vocabulary and morphosyntactic development in the POST group than in the PRE group. These findings are consistent with the scarce previous studies on children's language development during the pandemic. ConclusionsThe measures adopted during the COVID-19 pandemic have had a negative impact on the language development of children under 3years of age. It is necessary to pay special attention to these children due to the needs they may require in the immediate future.

Early Childhood Care and Education in Botswana: Implications for access and quality

Background: The value of Early Childhood Care and Education (ECCE) is recognised as beneficial to the child and society. Research evidence on pre-primary ECCE access and quality in Sub-Saharan Africa is scarce.Aim: The aim of this article is to examine Botswana’s pre-primary school programme in enhancing accessibility and quality of ECCE provision.Setting: The study was conducted in 12 of the 24 primary schools implementing the pre-primary programme in a Gaborone sub-region.Methods: Adaptations of the Levesque Access Framework and Woodhead Quality Framework were applied to this qualitative research study. Using semi-structured interviews, 11 pre-primary teachers, 5 school heads or Heads of Department, and 3 Principal Education Officers (PEO) were interviewed, and the data collected was analysed thematically.Results: The findings suggest that the main barriers to the effective pre-primary programme rollout are supply-side and systemic. These barriers represent the public institutional environment (e.g. funding, inter-governmental co-ordination), policy design (e.g. the physical infrastructure delivery model, administrative barriers, enrolment policy), and programme implementation (enrolment practices, teaching personnel, learning materials, and assessment of learners).Conclusion: Although over 600 public schools have implemented the pre-primary programme, meeting the objectives of universal access, equitability, inclusivity, and quality remains a challenge in Botswana, as in many other African countries.Contribution: The findings offer research frameworks and evidence for understanding pre-primary ECCE accessibility and quality. Further, the research has policy, programmatic, and practice-based implications for pre-primary educators and policymakers.

Challenges to the Quality of Early Childhood Education Delivery at Pre-Primary Level at Five Schools in the Zambezi Region (Namibia)

Objective. The primary purpose of this study was to document the nature of challenges faced by pre-primary teachers when delivering quality early childhood education at pre-primary schools in the Zambezi Region. The quality of delivery of early childhood education is crucial for the cognitive, emotional, physical and social wellbeing of children (Ministry of Education, Arts, and Culture [MEAC], 2016). The researcher envisaged that a high standard of delivery of early childhood education will potentially equip young children with skills and knowledge that will be important to their success during primary schooling. The study should prove essential for policy makers and other stakeholders to help them deliver early childhood education in pre-primary schools of a high standard in five schools that were purposefully selected for the study. 
 Materials & Methods. The case study collected qualitative data using face-to-face interviews with pre-primary teachers and junior primary heads of department. Observations were conducted in pre-primary classrooms during the lessons. In addition, the documents were reviewed, which included ministerial documents, journals and newspaper articles, to gather data that could be used to facilitate the improvement of early childhood education in pre-primary schools.
 Results. The central question of study was: What are the challenges of quality delivery in early childhood education at the selected pre-primary schools? In order to answer this primary question, the following supporting questions were formulated: What are the challenges faced by pre-primary teachers in order to implement a curriculum that will provide quality early childhood education at the five schools in the Zambezi Region of Namibia? How does the classroom environment influence the delivery of quality early childhood education at the five selected pre-primary schools? 
 Conclusions. The findings of the research revealed that several challenges inhibit the quality of delivery of early childhood education at the five pre-primary schools selected for the study in the Zambezi Region. These challenges included: the use of SiLozi as a medium of instruction, a discrepancy between learning objectives as presented in teacher’s manual and in the curriculum, the lack of educational corners, the lack of teaching materials, the lack of recreational facilities and a deficiency in parental involvement in their children’s schooling.

Linguistic interactions at nursery school and language acquisition of toddlers from low-income bilingual immigrant families and monolingual families

ABSTRACT Toddlers from low-income and language-minority immigrant families are at risk for language difficulties due to early disparities in the quality of their home language environment. The present longitudinal study extends previous research by investigating nursery teachers’ communicative modalities and functions, and their relations with the conversational responsiveness and vocabulary of 42 (50% F) equivalent low-income monolingual and bilingual toddlers. Communicative modalities and functions were coded from videotaped interactions between teachers and small groups of toddlers at 18, 24, and 30 months at nursery school. Vocabulary in the majority or societal language (Italian) was assessed at 30 months using teachers’ reports. The results showed that teachers used bimodal utterances (gesture + speech) more with bilinguals than monolinguals from 18 to 30 months while the reverse was true for unimodal spoken utterances. Bimodal utterances and language scaffolding strategies promoted toddlers’ communicative initiatives in both groups and were longitudinally associated with children’s vocabulary at 30 months. These results show that the school context may act as a protective proximal environment for stimulating and favoring majority language acquisition from the earliest stages of development in children from low-income and language-minority families.

Role of Singing Games in Character Formation among Pre-Primary School Children

The purpose of this study was to establish the influence of singing games on the moral development of pre-primary school children. Specifically, the study sought to find out the influence of singing games on character formation among pre-primary school children. The study employed a descriptive survey design. The target population was 2,446 respondents, constituting 2000 pre-primary school children, 230 teachers, 215 parents, and the Kisii South Sub-County ECDE Director. Krejcie and Morgan's (1970) table was used to obtain a sample of 331 respondents. Simple random sampling and purposive sampling were used. Questionnaires, interviews, and observation schedules were used as tools of data collection. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were coded and categorized through the identification of themes and patterns. The study found that most of the children who entirely and actively participated in singing games at school had a positive change in their moral development through character formation, with a correlation value of r=.260. These findings signified that for society to have morally upright children, there is a need for emphasis on more singing games by curriculum designers and educators for effective moral development. The findings will be useful to teachers, educational policymakers and practitioners, and educators in fine-tuning their pedagogical approaches, allocating teaching and learning resources, developing and designing the curriculum, and assessing the effectiveness of singing games on moral development. Finally, this study would help enhance the existing literature upon which potential researchers will base related work.

Exploring Administrators’ Use of Instructional Advisory Approaches in Enhancing Implementation of Structured Play Activities in Tanzanian Government Pre-primary Schools in Longido and Monduli Districts

This study examines the extent to which school administrators use instructional supervisory approaches in enhancing implementation of structured play activities in government pre-primary schools in Longido and Monduli Districts, in Arusha Region in Tanzania. The study was guided by Clinical Supervision Model developed by Goldhammar (1969,1993). Convergent research design was used because it allowed the researcher to collect quantitative and qualitative data so as to understand the problem in detail and triangulate the collected information. The sample consisted of 268 participants who were obtained through stratified, purposive and simple random sampling techniques. Data were collected through questionnaires, interviews, document analysis, and lesson observation. These tools were validated using triangulation and experts in the fields of research, administration and early childhood education. Reliability was ensured using. Cronbach alpha and triangulation techniques. Quantitative data were analyzed descriptively while qualitative data were analyzed using thematic analysis. The findings indicate the school administrators’ supervisory role on the implementation of structured play activities in pre-primary classes to be very low. Findings also show that school administrators used several approaches in supervising teaching and learning in pre-primary classes. These includes checking pre-primary teachers’ schemes of work and lesson plans, classroom observation, monitoring of pre-primary pupils’ progress and checking pre-primary pupils’ works. However, the approaches were moderately used by the school administrators. Structured play activities were also sparingly used. The study recommends that school administrators have to use instructional supervisory approaches to enhance application of the implementation of structured play activities in teaching and learning.

Awareness of the spectrum condition of autism among pre-primary school teachers in Western Kenya

BACKGROUND 
 Autism is a spectrum of neurodevelopmental disorders exhibited in early childhood with variable manifestations as children grow up. However, the level of awareness of the condition is poorly understood among pre-primary school teachers. This study, therefore, assessed the awareness of the spectrum condition of autism among pre-primary school teachers in western Kenya. 
 MATERIALS AND METHODS 
 A descriptive cross-sectional study design was employed and data collected from 321 participants using semi-structured questionnaires and Key Informant interviews. The participants were selected using purposive sampling. The quantitative data were analyzed using SPSS version 20 and qualitative data analyzed thematically 
 RESULTS 
 The response rate was 76.9% with 16.8% (41) males and 83.2% (203) females. A total of 41.5% (n=110) of the teachers had never heard of autism. Of all teachers who had heard of autism, 100% (7) were from special needs schools, and 64.4% (67) and 45.1% (60) were from public and private schools, respectively. About 78.8% (105) of teachers perceived autism as a neurodevelopmental disability and academically challenged children, 15% (20) as a psychiatric illness similar to madness, 4.5% (6) as spiritual affliction/demon-possessed children and 1.5% (2) as parental neglected children. 
 CONCLUSIONS AND RECOMMENDATIONS 
 This study shows that pre-primary school teachers have inadequate awareness of the spectrum condition of autism, and this limits educational service delivery. This study therefore recommends special training for pre-primary school teachers and improvement of the curriculum and training to include the spectrum condition of autism.

Epidemiologic characteristics and influencing factors of influenza outbreaks in Guangdong Province, 2015-2022

Objective: To grasp the epidemiological characteristics of influenza outbreaks in Guangdong Province by analyzing the outbreaks of influenza-like cases reported in Guangdong Province from January 2015 to the end of August 2022. Methods: In response to the outbreak of epidemics in Guangdong Province from 2015 to 2022, information on on-site epidemic control was collected, and epidemiological analysis was conducted to describe the characteristics of the epidemics. The factors that influence the intensity and duration of the outbreak were determined through a logistic regression model. Results: A total of 1 901 influenza outbreaks were reported in Guangdong Province, with an overall incidence of 2.05%. Most outbreak reports occurred from November to January of the following year (50.24%, 955/1 901) and from April to June (29.88%, 568/1 901). A total of 59.23% (1 126/1 901) of the outbreaks were reported in the Pearl River Delta region, and primary and secondary schools were the main places where outbreaks occurred (88.01%, 1 673/1 901). Outbreaks with 10-29 cases were the most common (66.18%, 1 258/1 901), and most outbreaks lasted less than seven days (50.93%,906/1 779). The size of the outbreak was related to the nursery school (aOR=0.38, 95%CI:0.15-0.93), the Pearl River Delta region (aOR=0.60, 95%CI:0.44-0.83), the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=3.01, 95%CI:1.84-4.90), the influenza A(H1N1) (aOR=2.02, 95%CI:1.15-3.55) and the influenza B (Yamagata) (aOR=2.94, 95%CI: 1.50-5.76). The duration of outbreaks was related to school closures (aOR=0.65, 95%CI: 0.47-0.89), the Pearl River Delta region (aOR=0.65, 95%CI: 0.50-0.83) and the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=13.33, 95%CI: 8.80-20.19; 4-7 days compared with ≤3 days: aOR=2.56, 95%CI: 1.81-3.61). Conclusions: An influenza outbreak in Guangdong Province exhibits two peaks, one in the winter and spring seasons and the other in the summer. Primary and secondary schools are high-risk areas, and early reporting of outbreaks is critical for controlling influenza outbreaks in schools. Furthermore, comprehensive measures should be taken to prevent the spread of the epidemic.

COVID-19 Pandemic in Pre-Primary Children in Tanzania: Strategies and Challenges

This study aimed at exploring challenges faced by pre-primary children during COVID-19 pandemic and the strategies adapted to help them to cope with the pandemic in a Tanzanian context. Fifteen parents whose children were in pre-primary schools were interviewed through mobile phones on the challenges faced children and the strategies used to help their children cope with COVID 19 pandemic. The main challenges reported were loneliness and inactiveness. Majority of the parents could not device strategies that would help their children cope with the pandemic but reported to connect their children with the media such as educative cartoons. Based on the findings, it is recommended that necessary measures should be taken to empower parents to stimulate, play, communicate, and support their children’s learning at home. Guidance should be provided to parents on how to engage their children in age-appropriate ways in order to develop literacy and numeracy skills at home.

Symmetry-aware deep neural networks for high harmonic spectroscopy in solids.

Neural networks are a prominent tool for identifying and modeling complex patterns, which are otherwise hard to detect and analyze. While machine learning and neural networks have been finding applications across many areas of science and technology, their use in decoding ultrafast dynamics of quantum systems driven by strong laser fields has been limited so far. Here we use standard deep neural networks to analyze simulated noisy spectra of highly nonlinear optical response of a 2-dimensional gapped graphene crystal to intense few-cycle laser pulses. We show that a computationally simple 1-dimensional system provides a useful "nursery school" for our neural network, allowing it to be retrained to treat more complex 2D systems, recovering the parametrized band structure and spectral phases of the incident few-cycle pulse with high accuracy, in spite of significant amplitude noise and phase jitter. Our results offer a route for attosecond high harmonic spectroscopy of quantum dynamics in solids with a simultaneous, all-optical, solid-state based complete characterization of few-cycle pulses, including their nonlinear spectral phase and the carrier envelope phase.

Working in partnership with all our families

Sarah Hardwell, nursery director for Little Peanuts Day Nursery and Forest School in York, shares insights into how her nursery works with families to ensure the best outcomes for the children in their care.

QUANTITATIVE SIGNATURES OF BRAIN COGNITION IN YOUNG CHILDREN USING TASK-BASED EEG SIGNALS

Cognition is the practice of processing knowledge through mental processes. Understanding cognitive functions of the brain in young children helps in identifying neurodevelopmental disorders at early stages. Most studies used to diagnose neurodevelopmental disorders are based on behavioral scales. But most children with neurodevelopmental disorders are non-verbal. Thus, the goal of this research is to perform a task-based analysis of cognitive skills in children using electroencephalographic (EEG) signals. Spectral and fractal features of the EEG signals were acquired from pre-primary school children ([Formula: see text]) during arithmetic and path-finding cognitive tasks. The acquired signals were decomposed into various sub-bands. Investigations on the time-domain Higuchi Fractal Dimension (HFD) analysis and frequency domain Power Spectrum Analysis features demonstrated the dominance of the Theta band over the other subbands. The frontal electrode exhibited more workload in the arithmetic task, indicating the involvement of frontal regions and the temporal areas (T8) which were actively involved throughout the path-finding task, showing the activity related to spatial perception and navigation. Thus, the statistical information obtained from the spectral and fractal analyses seems to provide quantitative evidence of the variations in cognitive skills of young children thereby enhancing inferences about neurodevelopmental disorders.

EMI and CLIL in Asian schools: A scoping review of empirical research between 2015 and 2022

As the role of English as a global language grows, many governments in the Asian region have been promoting the use of English as medium of instruction (EMI) in universities and schools. In recent years, the use of EMI has been promoted in the form of Content Language Integrated Learning (CLIL) in many pre-primary, primary and secondary school systems in Asia. Because this focus on the school sector is relatively new, there seems to be relatively limited empirical research on the implementation of EMI and CLIL in primary and secondary schools in Asia. Using scoping review methodology, this paper aims to ‘map the terrain’ by providing an overview of the contexts and focus areas of empirical research conducted in the last seven years (2015–2022). The findings highlight gaps in the existing body of literature, including a lack of research in primary school and early childhood contexts, limited research in some countries in the Asian region, and a relatively narrow range of research focus areas, stakeholder perspectives and methodological approaches. These findings highlight areas that future researchers may consider as they investigate EMI and CLIL in school contexts in Asia.

Spanish validation of the Pediatric Quality of Life Inventory (PedsQL™ 4.0) for parent report for toddlers (ages 2–4)

Background/objectiveHealth-related quality of life is a concept that includes aspects about physical, emotional and social well-being. The aim of the study was to validate the PedsQL for parent report for toddlers in Spain and provide reference data in a Spanish population.MethodThe sample included 478 parents (89.5% mothers) of children aged 18–36 months (M = 26.75 months). Sociodemographic data were gathered, and the PedsQL and Kiddy-KINDL-R were completed by the participants.ResultsThe fit of the original structure of the PedsQL was acceptable (CFI = 0.93; TLI = 0.92; RMSEA = 0.06), and the results showed good internal consistency (α = 0.85). The items about nursery school were excluded, since not all the toddlers attended this type of educational centre. Significant differences were found in physical health and activities and in the total mean in terms of parent education level, and in social activities regarding gender. For the normative interpretation of the PedsQL, the first, second and third quartiles corresponded to 77.78, 84.72 and 90.28, respectively.ConclusionsThis instrument is not only useful to individually evaluate the quality of life of a child with respect to his/her group, but also to measure the efficacy of a possible intervention.

Knowledge and reported use of evidence-based practices by early intervention professionals working with autistic children in Saudi Arabia

BackgroundThis study examined early intervention professionals’ attitudes towards, knowledge and reported use of evidence-based practices for autistic children in Saudi Arabia. MethodAn online survey was completed by 173 early intervention professionals working directly with autistic children (under the age of six years) in early intervention programs at public and private nursery schools/ day-care centres in all provinces of Saudi Arabia. ResultsParticipants reported greater use of evidence-based practices than emerging and unsupported practices. However, some evidence-based practices (EBPs) were reported to be used infrequently - less than once per week on average. Unsupported practices were also reported to be used more frequently than emerging practices. Participants were more likely to report using EBPs when they had more knowledge of EBPs, they said that they would have a higher level of willingness to use EBPs if it was required by authorities, and the location of their school/centre was a major city. Participants were also more likely to report using emerging practices when they had less knowledge of EBPs and more knowledge of emerging practices. A similar pattern was also found for unsupported practices. The most reported used sources of information on early intervention practices were other teachers, professional development inside the workplace, and general web searches. Research literature was one of the reported least commonly accessed sources of information. ConclusionsThese results add to the scant Saudi literature investigating autism early intervention practices, highlighting the knowledge and reported use by professionals of these practices. The implications of these findings for the facilitation of knowledge transfer into practice are discussed.

Experimental data about the evacuation of preschool children from nursery schools, Part II: Movement characteristics and behaviour

This article presents experimental data sets about the evacuation movement and behaviour of preschool children observed during 15 evacuation drills in 10 nursery schools in the Czech Republic involving 970 children (3–7 years of age) and 87 staff members. The movement characteristics and behaviour of the children were studied in 100 measurement areas defined on evacuation routes in corridors, on staircases, and in doorways. A total of 23000 data points were gathered to investigate travel speeds, specific flows, densities, and their relationships, as well as movement behaviour and procedures during the evacuation drills. Variables of interest included the levels of physical assistance provided to children, hand holding behaviour, use of handrails, and footstep patterns on staircases (i.e., “marking time” patterns). The observations revealed that the movement characteristics of preschool-age children were age-dependent. On horizontal routes, higher travel speeds were measured in corridors (mean value 1.9 m s−1) than for landings of straight staircases (mean value 0.96 m s−1) and doorways (mean value 0.99 m s−1). Nine behavioural statements summarising the evacuation movement behaviour of preschool children observed in this study are presented in order to enrich future applicability of the findings in engineering applications (e.g., evacuation modelling).

Child health screening program in French nursery schools: Results and related socioeconomic factors.

The study aims to describe the output of routine health screening performed in French nursery schools by the maternal and child health services among children aged 3-4 years and to quantify the level of early socioeconomic health disparities. In 30 participating départements, data on screening for vision and hearing impairments, overweight and thinness, dental health, language, psychomotor development, and immunizations were collected for children born on specific dates in 2011 and enrolled in nursery school in 2014-2016. Information was collected on the children, their socioeconomic characteristics and on the school attended. Odds of abnormal screening results were compared for each socioeconomic factor by logistic regressions adjusted for age, sex, prematurity and bilingualism. Among the 9,939 children screened, prevalence of disorders was 12.3% for vision, 10.9% for hearing, 10.4% for overweight, 7.3% for untreated caries, 14.2% for language and 6.6% for psychomotricity. Newly detected visual disorders were more frequent in disadvantaged areas. Children with unemployed parents were three time more likely to have untreated caries and twice as likely to present language or psychomotor impairments; 52% were referred to a health professional following screening compared to 39% of children with employed parents. Except for children in disadvantaged areas, vaccine coverage was lower among disadvantaged groups. The prevalences of impairments, which are higher among disadvantaged children, highlight the potential preventive impact of systematic screening under the comprehensive maternal and child healthcare program. These results are important to quantify early socioeconomic inequalities in a Western country known for its generous social welfare system. A more holistic approach to child health is needed with a coherent system involving families and aligning primary care, local child health professionals, general practitioners, and specialists. Further results are needed to evaluate its impact on later child development and health.

Investigation of Bioaerosols and the Microbiological Indoor Air Quality in an Urban Nursery School in Port Harcourt, Nigeria

Aims: This study was aimed at investigating the microbial quality of air within the confines of nursery school children. Early exposure to these indoor pollutants can lead to major public health concerns which include acute respiratory tract infections, allergies as well as cancer.
 Study Design: Random sampling approach was used in the collection of the samples. Air samples were collected from two different classrooms in a nursery school.
 Place and Duration of Study: Air samples were collected within the confines of the nursery section of the Demonstration Primary School in the University of Port Harcourt, Rivers State, Nigeria every other weekday in the month of May 2022.
 Methodology: Culture media were placed at the four corners of two classrooms in the nursery section. This nursery class comprised of children between the ages of 4-5 years Nutrient, MacConkey and potato dextrose agar media were used to culture airborne microorganisms during the study. For differential identification of bacteria, citrate, motility, oxidase, indole, catalase, methyl red Voges Proskauer, triple salt iron agar, sugar fermentation tests were carried out.
 Results: Both bacterial and fungal species of medical importance, such as Bacillus, Shigella, Micrococcus, Serratia, Proteus, Yersinia, Enterobacter, Penicilium, Aspergillus, Candida, Microsporum. Exophiala and Mucor spp were isolated in this study. The most predominant bacterial species among the isolates in the study was Bacillus sp. with the percentage occurrence of 25%. Shigella and Yersinia species had the percentage occurrence of 16.67% respectively other species like Serratia, Micrococcus, Enterobacter and Proteus each had percentage occurrence of 8.33% which was the lowest occurrence. All the fungal isolates had similar or equal percentage occurrence (16.67%).
 Conclusion: Exposure to microbial aerosols in nursery schools can lead to several health complications. Thus, recognition, control and monitoring of air quality in schools are crucial in limiting the spread of airborne pathogens.

Studies on pre-primary learners of foreign languages, their teachers, and parents: A critical overview of publications between 2000 and 2022

AbstractThis article offers insights into trends found in 74 empirical studies on teaching and learning a foreign language (FL) in pre-primary schools in 25 countries. The emerging picture is like that of primary-school programs: most are implemented in English, mostly owing to parents’ enthusiasm rather than evidence on long term FL benefits. Researchers focus on measurable outcomes in the FL rather than embedding studies in what early childhood education and language policies aim for: developing children not only in a FL, but also in their first language and emotional, cognitive, and social domains. A short literature review on how children learn languages and what necessary conditions include, is followed by the evidence empirical studies offer along themes found in them. Research has revealed encouraging results as well as weaknesses, whereas most authors frame their findings in positive terms. Overall, the younger the children the slower their rate of FL development. The field is dominated by FL experts; it would benefit from early childhood expertise to shift it towards the whole child. Although the increase in research is significant, more is necessary to build a model of pre-primary FL programs. A table available online complements the text.

A pilot intervention to improve uptake and equality of childhood influenza vaccination in an area of Wales, through the introduction of a mixed delivery model including nursery school immunisation sessions.

The schools-based influenza vaccination programme has seen consistently high uptake in Wales, however coverage in pre-school two and three-year olds is lower. One health board area (Cwm Taf University Health Board (UHB)) developed an intervention to offer live attenuated influenza vaccine (LAIV) for three-year olds attending nursery schools alongside the existing general practice (GP) programme. During the pilot, sessions were delivered by health visitors, working with school nurses. The mixed delivery model led to vaccination data being recorded in two separate data systems. To evaluate the impact of the pilot on overall vaccine uptake, data linkage was carried out within the Secure Anonymised Information Linkage (SAIL) Databank. Overall influenza vaccine uptake was calculated for each health board in Wales for two and three-year olds for the 2015-16, 2016-17, and 2017-18 influenza programmes. Uptake in two-year olds in Cwm Taf UHB and also uptake in three-year olds in other health boards in Wales were the comparison groups. Uptake of influenza vaccine in the 2015-16 (pre-intervention) period was 41.0% for three-year olds in Cwm Taf UHB. Following the intervention, coverage increased to 70.7% and 71.5% for 2016-17 and 2017-18 respectively. The same increases in uptake were not seen in two-year olds in Cwm Taf UHB or in three-year olds in non-intervention health boards. In Cwm Taf UHB resident three-year olds in 2015-16 there was an inequality gap in the uptake of 17.4 percentage points between the most and least deprived areas. Uptake increased across all deprivation quintiles in 2016-17 and 2017-18; and the inequality gap decreased to 10.3 and 13.4 percentage points respectively. Influenza vaccination uptake and equality of uptake in three-year olds can be improved by adopting a mixed delivery model across nursery school based immunisation sessions with the additional option of influenza vaccination at GPs.