Abstract
What is Known
School readiness ensures a successful home to school transition. However, not much is known about physical readiness. This study explores caregiver perceptions of physical school readiness and resilience in preschool children.
What This Study Adds
Thematic and content analysis revealed that children who were physically ready for school exhibited autonomous gross and fine motor abilities. Caregivers, including parents and other adults, described mental resilience as persistence in the face of difficulty. They reported concern for bullying when their children showed lack of physical readiness, self-confidence, coordination, and cognitive skills. Other conditions such as stunted growth and being overly-pampered by caregivers were presented as diminishing resilience.
Individual child readiness for school varies across context and situations. While exciting for some, others feel anxious and exhibit separation anxiety, which can affect their engagement and learning.1,2 Most children from low- and middle-income countries (LMIC) risk entering kindergarten with less requisite skills, especially those from low socioeconomic backgrounds. 3 Cameroon, an emerging middle-income country is endowed with a population dominated by children (49%, Cameroon Office Annual Report, 2023). 4 This represents the country’s potential for growth. Such potential is, however, dependent on the quality of care and experiences children are exposed to in their early years. Governmental regulation on school entry age remains at age 4 years for nursery/preschool and 6 years for primary/first grade in Cameroon. The profit-driven motive of most lay-private and mission schools in the country lures the admission of children way below the required minimum age. In addition, the fast-evolving family dynamics in Africa drives women to engage in multiple roles as workers and primary caregivers and thus precipitates the tendency to enrol children in school earlier than required.
The first few years of life are foundational and determines success in every domain later in life. 5 School readiness refers to the requisite school entry skills that facilitate subsequent personal and academic success. Prospective-longitudinal studies have established that the most important indicators of school readiness are cognitive (math and reading) and attentional.6-9 Beyond these, child task-orientedness in the classroom represents an additional precursor skill, according to kindergarten teachers. 2
Physical preparedness is rarely addressed in literature. However, when acknowledged and tested, motor skills represent important predictors of long-term achievement and thus essential precursors to school readiness.5,8 Physical play keeps children healthy and boosts their self-esteem. 5 Children need to run around, skip, jump and climb from a very early age to gain balance, build confidence and independence required to thrive in school. 10 Children’s physical well-being influences resilience and achievement. 2 Resilience refers to a dynamic process that involves positive adaptation skills within the context of significant adversity. In the context of this study, resilience is perceived as a preschool child’s tendency to be confident, easily pick up when they fail, and sustain effort on tasks perceived as difficult or boring.
Physical maturation is often measured by observable changes in growth and prowess. Motor skills develop rapidly from infancy through early childhood. 5 Providing avenues for children to development such skills is essential in child flourishment. 10 Regardless of cultural background and socio-economic status, WHO (2019) recommends that caregiver replace sedentary screen time with more moderate- to vigorous-intensity physical activity in childhood, while preserving sufficient sleep to ensure optimum development. 11 Child’s play remains key in early childhood. 10
Early childhood fine motor milestones are typically monitored by healthcare professionals to identify motor processing delays and when detected to provide early intervention services that aim to improve their physical prowess. 11 These are typically classified into gross and fine motor abilities. Gross motor skills require coordination of an individual’s arms, legs, and other large body parts for actions such as running, jumping, and throwing. 5 For example, in typical development, by the time children turn 2 years old, they become able to jump 2 inches on both feet, walk up and down 3 stairs, and throw a small ball 3-5 feet in the direction of a target. 26 Fine motor skills require coordination of smaller movements between the fingers, hands, and feet for actions such as picking up and grasping small objects (eg, pincer grasp). 12 These actions involve dexterity in order to manipulate smaller movements and objects.5,13
Fine and gross motor skills are strongly linked and predict subsequent development. Early motor development presages later cognitive skills like reading and math. 14 Optimal motor skills facilitate discovery learning and social interaction in early childhood and are thus vital for school readiness. Extensive research has linked the motor system to mental simulation, defined as skills associated with the construction of mental models during reasoning.5,15 This likely determines individual tendencies to explore their environment and build confidence. Using data from the 1970 British Cohort Study, Cortes et al. 12 investigated the relationship between gross and fine motor skills at age 22 months and subsequent outcomes at ages 42 months and 10 and 16 years. Compared with gross motor skills, fine motor skills were stronger predictors of later visuospatial deductive reasoning in adolescence. Because fine motor skills facilitate cognitive mapping of visual representations to emerging verbal and mathematical concepts, they are likely to influence future reasoning. 16 This may allow for more fine-tuned mapping during mental model construction in deductive reasoning. Numerous studies have reported links between fundamental motor skill acquisition and neuromotor, cognitive, social, and emotional development in childhood.17-20 In fact, early childhood fine motor skills also predict later academic achievement, especially in reading and mathematics.5,8 Fine motor skill improvement through drawing practice improve child creativity and self-regulation skills, which are highly important for future achievement. 5
Classical Piagetian theory 21 established a connection between child motor and cognitive abilities. A child’s independent exploration and manipulation of objects in the environment there generates constant restructuring and expansion of schema, which enhances child metacognition and resilience. Similarly, preschool children assert their power and control over the world through directing play and other social interaction by attempting new tasks and joining or initiating activities together with friends. 22 A sense of guilt emerges when children are not supported in their sense of initiative by caregivers. Vygotsky 23 highlights the value of a child’s interaction with the environment for the development of higher cognitive function and emotional regulation. Fine and gross motor abilities from this perspective can influence their resilience. From Nsamenang’s 24 social ontogenetic perspective, preschool children in the African context are novice social apprentices expected to recognize, think, and rehearse social roles as they observe and participate in activities at home. They develop fine and gross moto skills in such processes, meant to prepare them for formal schooling.
Sub-Saharan Africa has the largest number and proportion of preschool children (29.4 million, or 44%) compared to any other region with developmental risk. 25 Consequently, research on school readiness in the Sub-Saharan region has been relatively scarce. The early childhood transition from home to school has always been challenging for both parents and children. There have been traditional school readiness assessments anecdotally mentioned in some African communities which use a physical developmental milestone to determine whether a child was ready to start school. Specifically, if a child can reach over the head to touch the opposite ear, indicates sufficient physical growth and coordination for formal education (https://waldorfearlychildhood.org/wp-content/uploads/2022/08/Guidelines-for-Observing-School-Readiness.pdf). Although not documented, recent school entry requirements seem to have moved toward cognitive, social, and emotional readiness. To our knowledge, the focus of school readiness research has been in the socio-emotional and cognitive domains with limited regard to physical prowess. 26 Most studies have also been quantitative.
Caregivers such as parents and tutors that may or may not be adult family members seem to have distinct assumptions and beliefs that characterize child readiness for school that are beyond the age 4 government school entry requirement. The purpose of this mixed methods study is to describe caregiver perceptions of what makes a child physically ready for formal schooling in preschool age children. We also aim to explore their perceptions about how fine and gross motor skills influence child resilience.
Methods
Study Participants and Design
The study was carried out in Molyko, a semi-urban locality in Buea, in the Southwest Region of Cameroon, Central Africa. Molyko is a cosmopolitan hub of the Southwest region and other higher education institutions. The presence of educational institutions in Molyko has not only attracted people from all other Regions of the country in pursuance of their educational goals but also businesses which account for its cosmopolitan nature. Molyko has a good number of nursery and primary schools. To obtain data on caregiver perceptions of 3-to-5-year-old children’s physical readiness for school and the implications this has on their resilience, parents and teachers of such children were used. Quantitative and qualitative data was obtained but this paper focuses on the qualitative phase. Quantitative data was collected from a sample of 104 caregivers (67 % parents and 36% nursery- and school-teachers) using the UNESCO Early Childhood Development Index (ECDI2030). The Consolidated criteria for Reporting Qualitative Research (COREQ) guided the collection and report of the qualitative data.
The interviews were conducted by 2 female researchers. One, a university lecturer with a Ph.D. in Educational Psychology and the other, a primary school teacher and Master’s Degree holder in Educational Psychology. The data collectors had experience in collecting qualitative data from their participation in other qualitative studies. They had also done courses on qualitative research methods. In addition, before commencing data collection, a briefing session on recording, probing and note taking was held to refresh interviewers’ minds on ideal practices such as: being polite, flexible in accommodating interviewees preferred time and space, and how to probe for details. Interviewers had no prior relationship with the schools, parents nor the teachers that participated in the study.
The phenomenological design was used to describe the meaning parents and teachers attribute to 3-to-5-year-olds physical readiness for school and their interpretations of how such accounts for the children’s resilience at school. The purposive and consecutive sampling techniques were used to select study participants. Specifically, only parents who lived with their pre-school children and were involved in nurturing them were purposively recruited for the study. For teachers, a minimum of 5 years teaching experience at nursery schools constituted the inclusion criteria. It was assumed that the selected participants spent more time with the children thus were better placed to describe the physical milestones and indicators of resilience they exhibited. Consecutively, participants who met the criteria and consented to participate in the study were interviewed until data saturation was attained. All the participants were approached face-to-face at the nursery school centers in the course of dropping off the children in the early hours of the morning and pick up later in the day. Verbal and written consent was sought from the parents and teachers who met the criteria and were willing to participate. An appointment for the interview based on the participants convenience and availability was made during the first meeting. Some parents were willing but could not participate because of their very busy schedules. The qualitative sample constituted 20 participants (14 parents and 06 nursery school teachers). Table 1 represents a description of the demographic characteristics of the participants.
Demographic Characteristics of Participants.
All interviews were done face to face with some participants at the nursery school premises and others at their homes. Each interview lasted between 15 and 20 minutes. The rationale for the study and other ethical issues with regards to confidentiality, anonymity, freedom of participation and data use was clearly explained to participants. Verbal consent was also sought before commencing every interview.
Measures
To obtain the qualitative data, an interview guide was designed with respect to the study’s objectives aimed at describing caregiver’s perceptions about the physical readiness and resilience in preschoolers. The tool was piloted with a parent and a teacher at a nursery school out of the earmarked study area. Difficult words were identified and simplified as follows: fine motor skills to “things a child does physically with the fingers,” gross motor skills “things a child does physically with the hands or legs” and resilience “reaction of the children when faced with a problem.” The interview guide constituted questions such as “What are some of the things a child does physically with the hands, legs or fingers that makes you feel the child is ready to start school? If you were to access whether a child is physically ready to start school, what are the things that will make you disqualify a child as not physically ready? and how would you describe the physical appearance of a child you think is fit for school?” to assess caregiver perceptions of physical school readiness. Other questions were asked to get perceptions on resilience, such as “Please indicate some of the challenges you think children who are not physically mature or ready for school phase in the course of play or engaging in other school activities, how do the children feel or react when faced with such difficulty identified above?, how would a child you consider to be physically mature for school feel or react if faced with a similar problem?” were asked to get perceptions on resilience. Probes such as “describe an example of a typical case you observed,” “tell me more about it” were used. The last part of the interview guide constituted a section on demographic data of caregivers and the target child. This included data on age and sex of the caregiver and child concerned, relationship with child (parent or teacher), and caregiver profession and income level.
Data Administration and Analysis
The interviews were recorded and field notes also taken by the interviewers in the course. After every 02 to 03 sessions, the interviewers met to share notes and point out common concerns. The interviews stopped at a point after data saturation in the responses was noticed. The recorded audio clips were transcribed using utter 27 and coded by 2 persons. Thematic and content analysis was done through identification, categorization and description of emerging themes based on the quotations from participants voices. A bottom top approach was used where in responding to the questions, codes were assigned from the participants voices followed by categorization and generation of sub themes and later to main themes. To ensure data credibility, some participants were invited to verify that their voices were represented correctly. A session was held by the researchers for reflexivity on the analysis to avoid biases in data interpretation.
Ethical Approval and Informed Consent
This study was approved by the University of Buea, Faculty of Health Sciences-Institutional Review Board (approval no. 2413-02). The participants (parents and teachers) signed written consent forms that explained the purpose and benefits of the of the study. It also spelt out their freedom to participate and right to discontinue at will. In addition, the written consent had a statement assuring participants that data will only be reported in anonymised aggregate form.
Results
The participants were primarily female (75%) teachers (n = 6) and parents (n = 14) of 3 years (30%), 4 years (30%) and 5 years (40%) old children with an average monthly income of $ 280 ( ≤ 2 $200 - ≥ $500) with occupations as teachers (35%), business persons (25%), students (15%), farmer (15%) and lawyer (5%) and a pastor (5%). Qualitative data on caregiver perceptions about physical indicators that predict child readiness for school and resilience has been categorized and presented based on perspectives on gross motor skills, fine motor skills and resilience. The findings reflect both positive and negative attributes that depicts physical readiness for school. In presenting the quotations, P and T has been used to represent the sources from Parents and Teachers respectively.
Caregivers’ Perceptions About Gross Motor Abilities Predicting School Readiness
Beliefs about physical readiness, excretion, movement, support at home, bag carrying and independence emerged as themes that predict a child’s physical readiness for school. With regards to the strength of the themes, movement characterized by strength, stability and flexibility in large body muscles was earmarked as the strongest predictor of physical school readiness, followed by independence defined by the child’s desire to do things on their own. Another theme that emerged strongly as a predictor of physical school readiness is the child’s ability to support and participate in home tasks. Beliefs on physical readiness refers to physical gestures perceived to be determinants of a child’s ability to cope in school. A typical gesture indicating gross motor abilities reflecting readiness is captured in the voice of a parent (P3) who said
Caregivers earmarked support at home as an indicator of physical readiness for school. Child participation and willingness to engage in home tasks and run errands is perceived as vital in enhancing motor abilities that prepares them for school. This idea is captured in the words of some parents who said:
Movement described as strength, stability and flexibility in large body muscles, also emerged as a quality that defined physical readiness for school. This was echoed in the voice of T1 who said “
Caregivers also mentioned that frequently carrying bags indicated readiness for school. The tendency of preschoolers always carrying a school bag around the house was perceived as interest, strength and eagerness to start school. This perspective is captured in the words of some caregivers who said:
Excretion described here as the child’s ability to use the toilet and notify when they want to ease themselves was also seen as an indicator of physical readiness for school. A typical response the depicts this perspective was captured in the voice of a P 10 who said “
On the other hand, ill health, over pampering, physical challenges with height and body shape emerged as characteristics that retard child physical readiness for school. Ill health and physical challenges from the data refers to poor health conditions and physical developmental challenges such as being crippled or dumb. Health challenges children face such as mental disorder, spiritual attacks from family or friends and sickle cell anemia were perceived as issues that retarded physical readiness for school. This is reflected in P 11’s perspective who said:
With regards to height and shape, children looking physically very small and short were seen by some caregivers as unready for school as depicted in P 9’s voice who said: “
In addition, over pampered and spoiled children were considered not physically strong enough to face the challenges of school. To the respondents, giving children more than what is necessary and not allowing them to engage in tasks at home does not prepare them for school. This was captured in the typical responses below:
Perception of Fine Motor Skills Predicting School Readiness
Caregivers strongly reported that frequent writing, drawing, coloring and scribbling all over the house indicates fine motor skills that predict school readiness. Also, feeding, characterized by the child’s ability to eat well with very limited support and the tendency to dress up, care for the body and manipulate objects also emerged as factors that qualifies a child as ready for school. Frequent writing, coloring, drawing and scribbling all over the house was perceived as exhibition of fine motor skills indicating readiness for school.
This was remarked in a typical response from P 7 who said:
Caregivers also pointed out that a child’s ability to eat well with very little or no support predicts fine motor skills indicating readiness for school as captured in P 7’s voice: “
In addition, hygiene emerged as a theme indicating fine motor abilities for school. Hygiene as reflected in participants voices refers to the child’s ability to keep self-clean. In support of this, P 4 said “
In addition, manipulation of objects with fingers indicated the development of fine motor skills that made children ready for school. Most caregivers said: “
Perceptions on Resilience for Physically Ready and Physically Unready Children
Children that were physically ready for school were perceived to be more resilient when faced with challenges in the course of play or their engagement in school activities than those considered to be physically unready. The physically ready children were seen as strong, flexible, persistent, confident, neat and as children with an ability to manage challenges. These are reflected in the quotes and themes that emerged from the caregivers’ responses on how physically ready children respond to challenges in the course of play or other school activities.
Physically ready children are persistent, that is they are optimistic and exhibit a tendency to stay on task even when it gets tough. Such children as depicted in T 3s voice “
Such children as described by the teachers are confident, have trust in their abilities and are able to stay happy even in difficult times. This is depicted in the words of T 1 who said they are: “
Also, physically ready children are flexible that is they easily adapt and relate well with different peers. Such children as caregivers posit: “
In addition, physically ready children easily manage challenges. They improvise techniques to solve problems. This perception is reflected in the words of participants who said when physically ready children are faced with difficulty, they:
On the other hand, physically unready children are not resilient. They are easily bullied, fail, imbalanced, unable to persist, cry and sleep excessively and are usually unkempt. Physically unready children suffer from bullying and violence from peers. Such children as earmarked in the words of respondents:
“
Physically unready children fail or perform less optimally on academic tasks. Such children as voiced by T 3 are: “
Physically unready children also suffer from neglect. This was echoed in the voice of a caregiver who said “
Discussion
Readiness for school is vital for a child’s adaptation and successful learning outcomes. Extensive research has established the cognitive and socio-emotional aspects of school readiness with limited attention to the physical dimension. Most of the studies to our knowledge are dominantly western and of quantitative design. Very little has been done to capture the African perception of physical readiness for school despite its cultural heritage, history, and traditional practices. This study therefore explored caregiver perceptions about child physical readiness for school and definitions of resilience. Specifically, it examined qualitative perceptions of what constitutes physical readiness in terms of fine and gross motor abilities and the implications of such on children’s resilience.
According to caregiver perceptions, children who are physically ready for school are more resilient than those that are not. A physically ready child in terms of gross motor skills is one who is strong, stable and flexible in large body muscles. This is consistent with the perspective offered by Haibach-Beach et al 28 and Kompoliti and Metman, 28 which characterizes physical readiness by movement-running, jumping, climbing, throwing and catching balls and gaining balance in play. However, other perceptions of school readiness that emerged from the findings like support in house chores, beliefs about physical maturity and bag carrying appear distinct to the African context.
The variability in child rearing practices and cultural values accounts for the difference. Nsamenag’s 24 social ontogenesis captures support in house chores as an essential element of school readiness in the African context. 3-to-5-years-old in the African context are perceived as social apprentice ready to be initiated into adult roles. Children are expected to show interest and participate in social roles at home and in the community. When such an attitude is not exhibited, they are considered slow and unready for age-appropriate public participation (school). Unwritten African traditions that date back in the pre-colonial time and which hindered the documentation of significant events like date of birth and events of marriage render observability important. Thus, the visible nature of traditions seems important for school entry as well.
In addition, beliefs about physical readiness such as the one which states that a child is considered ready for school only when the right hand can flexibly touch the left ear or when the left hand can touch the right ear across the head seem to remain unique to the African context. It was assumed that anyone who passed the physical test must have attained a certain level of physical growth and maturity required for independence and success at school. They thus used other physical developmental milestones like physical growth, strength and ability to perform certain tasks as indicators of readiness for school. Assessment criteria for fitness was based on exhibited ability and not age.
With regards to fine motor skills, physically ready children are the ones who write, draw, color and scribble all over the house, manipulate objects at home, eat and dress up with limited support. This falls in line with Matheis and Estabillo 13 perspective on the value of dexterity in manipulating smaller movements and objects in nurturing fine motor skills which predict school readiness 8 and child self-regulation skills. 5
Resilience is reported as stronger in children considered to be physically ready as they tend to be more persistent, flexible, and can manage challenges. This aligns with Vygotsky’s 25 argument that, the more advanced a child’s private speech is, the higher his or her ability to self-regulate their emotions and activities. Similarly, the findings are consistent with Piaget’s 17 notion that expansion in a child’s schema through the processes of assimilation and accommodation as the child manipulates things in the environment leads to an advancement in problem solving and self-regulation skills. The more experiences and exposure a child has, the more the opportunity to develop motor skills that enhances cognition with implications for resilience. Also, many studies have associated fundamental motor skill acquisition with the development of neuromotor, cognitive, social, and emotional skills in childhood.17-19
We observed a tendency to view children who are not physically ready as less resilient and thus being at risk of peer intimidation, school failure, low self-esteem, excessive crying and sleep. This falls in line with Erickson’s 22 third stage of human development characterized by initiative versus guilt. Children who fail in developing a sense of initiative become guilty. Such children feel ashamed when they fail and interpret mistakes as personal failure. It becomes very difficult for them to adapt or transit successfully into school.
Our findings have implications for practice and policy. With regards to practice, it would be necessary for caregivers to prioritize the opportunity for children to play, manipulate things in their environment, engage in home tasks, feed and dress themselves with little support so their fine and gross motor skills can be enhanced. Overpampering and doing everything for a child stifles physical development and their sense of initiative which are valuable fitness in school. Policy on entry requirements needs to consider individual variability and not just the standard age (4 years stipulated by the Cameroon government) for entry into pre-school. Other standardized and contextually relevant measures of school readiness should be used to assess children before admission into nursery schools so they do not get to face challenges that will affect their esteem, learning outcomes and later development in life. In addition, inclusive policies and practices that will enable children support, collaborate and accept all others despite their differences are necessary to reduce bullying and anti-social behavior amongst the children.
In addition, concerns about bullying of children considered to be physically unready for school signals devastating effects on the development of the victimized children. There is need for intentional anti bullying actions at home and schools to promote acceptance and reduce bullying. Teachers can use creative strategies like role play, stories, puppets and cooperative learning to model and motivate prosocial behaviors towards children who are not physically strong. Safe spaces where children can quickly run to for support when they feel insecure should be created in the classroom and within the school premises. Parents and other caregivers at home should model respectful behavior like calm communication, empathy and avoid hurting others. Inclusive play where children share and celebrate variability in their abilities, appearance and interest has to be encouraged at home, within communities and at schools. Also, public acknowledgment and motivation of prosocial and inclusive behaviors exhibited by children rather than the popular focus on grades is vital in minimizing bullying.
Furthermore, the negative perceptions and attitude towards children with physical challenges, retarded growth and learning disabilities has to modified. Families and schools need to reflect and identify the stereotypes and myths they hold about physically challenged learners and modify their thoughts with accurate information about the strengths, talents and progress of such children. This has to be proceeded by practical actions such as the use of respectful language, creating inclusive school policies and learning environments from families and schools to support the acceptance and inclusion of physically challenged children. Training of families and education stakeholders on how to identify and modify negative perceptions of physically challenged children, valorize, include and support them in their learning is necessary within the Cameroon context.
The study has some limitations which constraints the generalizability and transferability of the findings. Firstly, the study reports the qualitative data obtained from a sample of 20 (6 teachers and 14 parents) participants selected from a particular community in the Southwest Region of Cameroon which limits the generalizability of the findings to a wider population. Nevertheless, this study taps information that is beyond a quantitative tool tested in a representative population across Africa like the ECDI. The findings depict the perspectives of caregivers within Buea, the earmarked community in Cameroon. The peculiarity of the area and participants limits the transferability of the findings to other areas. However, the vivid description of the study participants and area in the methods provides sufficient detail to help an audience judge the transferability of the findings to populations with similar characteristics. Secondly, in terms of the content scope, the study was limited to physical readiness and resilience. Interestingly, none of the caregiver verbatims mentioned screen time as a factor inhibiting cognitive and physical readiness and resilience. 26 This suggests that there is no perceived link and needs to be investigated in depth. A study that captures this dimension would be valuable for promoting regulated screen time in favor of physical, cognitive, and motor activity such as games, sport, and combined leisure activities with older children. In addition, the victimization and neglect of children considered to physically unready exhibited through bullying calls for a behavioral intervention within the context to modify negative perceptions and attitudes towards physically challenged children and foster inclusive practices that celebrate variability in learners.29,30
Conclusion
The main concern in this paper has been to examine caregiver perceptions of school readiness and how it influences child resilience. Using the qualitative approach through interviews with parents and teachers of 3- to 5- year-olds, it was realized that movement, participation in house chores and play were essential gross motor skills while writing and drawing, feeding and dressing with limited support and hygiene were the fine motor skills that predicted school readiness. Children considered to be physically ready for school were more resilient as they could manage difficulties, were more persistent, strong, flexible and confident than those that were not. The physically unready children could not transit successfully as they suffered from bullying, neglect, failure and imbalance. Physical development is essential in fostering socio-emotional and cognitive growth with implications for school readiness. Creating a rich, safe, warm, culturally inclusive, and stimulating environment is vital to enable children develop motor abilities which prepares them for a smooth transition into school.
Supplemental Material
sj-pdf-1-gph-10.1177_30502225251377847 – Supplemental material for From Home to Classroom: Exploring Caregiver Perspectives on Preschool Readiness and Resilience in Buea, Cameroon
Supplemental material, sj-pdf-1-gph-10.1177_30502225251377847 for From Home to Classroom: Exploring Caregiver Perspectives on Preschool Readiness and Resilience in Buea, Cameroon by Ijang Bih Ngyah-Etchutambe and Linda S. Pagani in Sage Open Pediatrics
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