CHEQ Provincial Summary

HELP analyses linking CHEQ data about children's early environments and experiences with Early Development Instrument (EDI) data about children's developmental health for the same children highlight the relationship between social determinants of health, daily experiences in the early years, and developmental health at age 5.

The CHEQ gathers information about many early childhood experiences. The Positive Assets and Childhood Experiences (PACE) analysis groups together parent/caregiver responses to CHEQ questions across several experiences, including screen time, sleep, physical activity, nutrition and positive experiences (such as playing outdoors, reading and singing with adults and peer experiences). See more details below.

View PACEs detail

CHEQ-EDI linkage shows that while each area of experience contributes to healthy development, there is also a cumulative effect such that the more assets children have, the more likely they are to be on track in their overall development (Figure 1).

CHEQ data also demonstrate an association between family socioeconomic status and children's early experiences. While this relationship is found across most individual areas of experience, Figure 2 shows that children in higher income households had more PACEs than children in lower income households.

The CHEQ was first piloted in the 2017 school year, and over time, almost three-quarters of BC school districts have participated. As of fall 2025, 30,903 BC children in kindergarten had a parent/caregiver complete a CHEQ about their early experiences and environments.

The map below shows which school districts participated in CHEQ collection in the 2025/26 school year. The graphic to the left shows the increase in the number of kindergarten students whose parent/caregiver completed a CHEQ over time. (To see which school districts participated each year, click on the year of interest.)

The participation rate for parents/caregivers in each school district varies by district and year of data collection. Between 2019–2025, the average participation rate across the 46 participating school districts was 38% of kindergarten children with a completed CHEQ.

The following charts summarize demographic information gathered through the CHEQ over three school years: 2023/24, 2024/25 and 2025/26 (N = 12,530).

• Household Income
• Education
• Household
• Siblings
• Born in Canada
• Languages

This report references combined CHEQ data collected over three school years (2023/24, 2024/25 and 2025/26, N = 12,530) and CHEQ data linked to EDI over the 2023/24 and 2024/25 school years. There were 9,867 CHEQ records collected in those two school years, and 4,968 were linked to EDI records.

CHEQ composite measures summarize data collected on four key areas of early experience on the CHEQ over three school years, 2023/24 to 2025/26.

• Nutrition & Sleep
• Physical Activity
• Language & Cognition
• Peer Experiences

Healthy community contexts and daily experiences promote healthy child development. Click through topics in the chart below for data demonstrating the relationship between parent/caregiver reports of children's early experiences collected through the CHEQ linked to teacher completed Early Development Instrument (EDI) questionnaires about their developmental health in kindergarten over two school years, 2023/24 and 2024/25.

Select a topic to explore:

• Sleep
• Screen Time
• Physical Activity
• Outdoor Play
• Risky Play
• Peer Experiences
• Social Support

Summary of the findings

Healthy habits start early. CHEQ-EDI analysis demonstrates that children meeting 24 Hour Movement Guidelines across sleep, physical activity and screen time in their early years were more likely to be on track in their overall development.

Outdoor & risky play strengthens development. Children with frequent opportunities for outdoor and risky play were more likely to be on track in their overall development.

What is risky play?

Thrilling and exciting forms of play involving uncertainty and the chance of physical injury (Sandseter, 2009) endorsed by the Canadian Paediatric Society as a facilitator of healthy child development. View the webinar recording of Embracing Risky Play with HELP Director and internationally recognized outdoor risky play experts Dr. Mariana Brussoni and Dr. Megan Zeni.

Social connection matters. Children who had more frequent opportunities to play with peers and had supportive neighbours were more likely to be on track in their overall development.

Increased screen time may offset healthy opportunities for sleep, physical activity and playing outdoors. Click through the chart below for CHEQ analysis showing the association between screen time and other early experiences over three school years, 2023/24 to 2025/26.

Screen Time and…

• Sleep
• Physical Activity
• Outdoor Play

Children's positive early experiences and developmental health outcomes reflect how well families with young children are supported. Families raising young children in BC today are facing many stressors ranging from housing affordability and cost of living concerns to uneven access to affordable child care and community supports. Below, some of these critical contextual issues are explored using CHEQ data. These topics and the impact of the pandemic on children and families are discussed further in HELP's Early Years Disrupted report.

Parental stress

The CHEQ asks parents/caregivers about their typical level of stress over the last six months. Between 2023 and 2025, 34% of parents/caregivers reported high or very high levels of stress. Parents/caregivers in lower income households were more likely to report higher stress levels. It is notable that one third of all parent/caregivers, regardless of household income, reported high or very high stress levels.

Parents/caregivers reporting high or very high levels of stress were more likely to report higher daily screen time for their children than parents/caregivers reporting lower stress levels.

Child Care

The CHEQ asks about the most frequent type of child care arrangement for children between the ages of 3 years and school entry. Between 2023–2025, 75% of the parents/caregivers reported that their child was in a child care arrangement other than parental care only. The percentage reporting that their child attended a licensed child care centre increased over the past seven years, from 31% (2019) to 44% (2025).

While more parents/caregivers were accessing licensed centre-based child care, between 2023–2025, most (80%) reported experiencing challenges when looking for early learning and child care arrangements. The top two barriers over time were availability of spaces and being on a waitlist. While cost was a top three barrier, it decreased as a reported barrier from 66% (2019) to 55% (2025).

Responses to questions on child care arrangements differed by respondent household income. Higher income households were more likely to report using licensed child care centres with the main barrier of availability while lower income households were more likely to report family care arrangements with cost as the main barrier to other child care arrangements.

Community Activities & Health Resources

Between 2023 and 2025, the top five most common community activities that parents/caregivers reported their children attended a few times per month or more were: park/playground, local community/recreation centre, public library or story time program, art, music or drama programs, and StrongStart programs.

View community activities question

CHEQ Questionnaire

In the last 12 months, how often did this child use the following community activities/resources?

• Art, music or drama programs
• Cultural activities programs
• StrongStart program
• Public Library or Story Time program
• Family Resource Centre (e.g., Family Drop-In Program, Local Neighbourhood House)
• Park/Playground
• Local community/recreation centre
• Faith-based program

Over one third of parents/caregivers reported barriers to accessing these types of programs, with the top five barriers being: availability, operating hours, not having time, cost, and the program being unavailable in the community.

Between 2023 and 2025, 92% of parents/caregivers reported that their child had accessed a health care professional within the last 12 months: Dentist (78%), Family Doctor/Nurse Practitioner (74%), Public Health Nurse (35%). Of those that reported barriers to accessing these health care professionals (45%), the most common barrier identified was appointment availability/waiting list (78%).

View health care question

CHEQ Questionnaire

In the last 12 months, did this child visit with any of the following health care professionals? (Check all that apply):

• Family doctor/nurse practitioner
• Public health nurse
• Dentist

Between 2023 and 2025, 38% of parents/caregivers reported that their child or family accessed a supportive program, including speech language intervention (44%), occupational therapy/physical therapy (28%), supported child development (25%), counsellor/therapist (19%). 35% reported barriers to accessing these services, with the most common barrier identified being appointment availability/waiting list (48%).

View supportive programs question

CHEQ Questionnaire

From 3 years to kindergarten entry, has this child or your family accessed any of the following programs or supports? (Check all that apply)

• Occupational therapy/physical therapy
• Speech language intervention
• Visit with another medical specialist
• Counsellor/therapist
• Supported child development program

The most common barrier to access identified across early learning and child care, community activities, and health resources was availability of spaces or appointments. Importantly, there is variability at the community level around types, availability and access to community activities and health resources. View available CHEQ School District and Neighbourhood Reports.

The CHEQ Provincial Summary highlights the many ways early experiences and environments shape children's development before they begin school. Through the data collected from participating BC school districts, a clear picture emerges: children's family contexts, daily activities, and community environments play a powerful role in supporting healthy development.

The Summary also emphasizes that inequities in positive early childhood experiences exist – families with fewer resources may face more barriers to opportunities for healthy development. Many families face significant challenges accessing the supports and resources they need, particularly lower income families. Barriers related to availability, waitlists, cost, and time constraints affect access to child care, community programs, and health services. Parent and caregiver stress, reported at high levels for many families, may also relate to children's daily experiences like screen time usage.

There are many research-informed resources to support parent/caregiver and early years service provider knowledge about healthy development. However, many families have the knowledge, but don't have access to necessary resources – programs, money, time, space, and community. Importantly, and as demonstrated in this report, supporting young children requires supporting families and investing in the environments in which they grow. This includes expanding family policies that enable parents to balance caring for young children and work, improving housing affordability, and reducing gaps and fragmentation in community-based early years programs. Some BC and Canadian policy recommendations and resources are listed below.

The CHEQ offers a valuable window into the lived experiences of young children and their caregivers across the province. By continuing to gather information on children's early experiences through the CHEQ and linking to developmental outcomes captured through the EDI, HELP and partners can shine a light on emerging needs, track progress over time, and inform efforts to ensure that every child in BC has the opportunity to thrive.

We gratefully acknowledge the financial support of the Province of British Columbia through the Ministry of Health for the CHEQ project.