Children are starting school in Norfolk still in nappies and not able to hold a pen or conversation, teachers say.
Schools are blaming the impact of technology for the shocking state some start school at, with "screen time" replacing human interaction.
It is holding back children's speech, vocabulary and even their physical skills, according to education experts.
Teachers and parents also claim the pace of modern life means children are not being given time to learn how to tie their shoes or put on coats.
Four-year-olds 'still in nappies'
Carole Jacques, manager at Earlham Early Years Centre in Norwich, said more children were coming into her nursery who were not toilet trained.
"A number of three or four-year-olds are still in nappies and there is not any medical reason for that," she said.
"There has also been a significant decline in language and communication skills among children coming in, not just verbal communication but being able to participate in games, being part of a group, being able to focus and listen - children find that difficult. We have adapted our routines and curriculum to try and support that."
Ryan Freeman, headteacher at Peterhouse Primary Academy in Gorleston, has also witnessed an increase in pupils coming into reception class with a lack of "basic life skills".
However, he said this was not the case across the board and that some children - including from the school's on-site nursery - were fully prepared by the time they reached school.
"There are definitely now far more children coming in needing to be taught things that they were not coming in with before," he said.
"On the flip side we have got an awful lot of children who are streets ahead of where they need to be when they come to nursery or reception. It is not a systemic problem.
"The parents have worked really hard with them on basic reading, writing, communication, sharing."
Sarah Johnson, who owns and manages the Norwich Montessori School in Colney, believes adults' busy lives are affecting children's development.
"They expect everything to be done for them so we show them how to do it for themselves to give them confidence," she said.
"It is communication, language, growth in motor skills, all these things you need to encourage at home, so we would definitely encourage parents to let the children do things for themselves.
"I think a lot of settings are encouraging that, but it is easier just for them [parents] to do it themselves as adults. It has changed noticeably over the years."
Amy Jones, from Norwich, whose son is currently in nursery, said: "As a mother on the go it is sometimes easy to forget your toddler is growing up and can or should put their own shoes or coat on.
"Instead, as you rush out of the door it is simply quicker to do it yourself.
"He is always so pleased with himself when he completes a simple task, and I feel so proud of him."
The technology problem
Many three-year-olds are now more familiar with iPads and apps than poster paints and mud pies, but schools and nurseries say this "digital native" status affects multiple aspects of their development.
Mr Freeman at Peterhouse Primary Academy said some children were showing early signs of addiction to tech.
He said: "It is having a big impact on how they come in ready for the start of school: low attention spans, finding it difficult to have face-to-face conversations, finding it difficult to go through a day without those devices, not being ready to come to school because they are up late or using them before school.
"An increasing percentage [of children] are coming in with low communication skills. Maybe if we are spending too much time on our phones we are not talking to our children so much."
Mr Freeman, who has a five-year-old-son, Jonah, said witnessing the changes in how prepared pupils were for their first year of school had affected him as a parent.
"As a teacher it heightens your senses," he said.
"My son will get an iPad if we are in a car on a long journey but board games are used at any other time. It worked for us so it will carry on working with him.
"We are always so conscious to be talking all the time - lots of communication, lots of language, lots of words, and if there is a word that he doesn't understand we explain it to him."
Ms Jacques at Earlham Early Years Centre said she had also seen an increase in the number of children coming in with issues caused by technology.
"They are over-stimulated, they are not able to be still and if you are looking at technologies there is no expectation that you will respond - you are just a passive observer," she said.
"There are a lot of children who struggle with the non-verbal elements of communication - eye contact, body language, being able to tune in and listen.
"If they don't have experience with socialising they find it difficult to be part of a group. Some have behaviour challenges because they are not able to express their thoughts and feelings and opinions."
She said the nursery school had shrunk its class sizes to cater for children who couldn't handle being in large groups.
The communication problem
For children whose early development is stunted - particularly in communication skills - there can be lifelong consequences.
Analysis of government data on SATs, year six reading tests, GCSEs and employment shows that children who start school with impeded speech and language development never catch up with their peers.
Maria Ward, 49, and Gary Yallop, 46, said their daughter Darcey had struggled with her speech when she first arrived at Earlham Early Years Centre but that therapy and support from the school had helped hugely.
The four-year-old is due to start school next year and her parents feel she is now ready.
Ms Ward said: "She has come on leaps and bounds. When she first started she was very shy, and when she was about three she had an issue with talking.
"The nursery helped me to get her into speech therapy and that worked wonders."
She added: "In society there is pressure to make sure she is prepared. Here they will understand if your child needs extra help with their independence."
Some teachers, such as Ms Johnson at Norwich Montessori School, have encouraged parents to play their part in helping children to learn.
"I think a lot of parents are very busy and they do not have time for some things. Sometimes there is a lot of rushing around and taking a little bit of time to build communication into the day helps enormously," she said.
The money problem
More than four in five teachers polled for a report in 2017 say inadequate funding is affecting how well children's needs are being met.
To improve school readiness teachers were making home visits before children start reception year or working with local private nurseries.
But nearly one in seven (13pc) said they did not have the funds or resources to help their children.
Earlham Early Years Centre is one of only three council-maintained nursery schools in Norfolk, along with centres in King's Lynn and Emneth.
But Carole Jacques, from the centre, said cuts to funding meant its budget was now very restricted.
"We used to have a speech and language therapist at the children's centre but they have gone," she said.
"We used to have a health visitor who was regular and got to know the families but they are now referred to different visitors. That has had quite a profound impact because they had known the families for a number of years and they were really well respected because they were well established."
Ms Johnson, from Norwich Montessori School, used to accommodate regular visits from primary school teachers to help older children prepare for the transition, but believes funding pressures have put paid to this in some schools.
"We used to have far more teachers coming around to visit the children in our setting but that does not really happen now. I don't think there is any money or time for teachers to come," she said.
What makes children 'school ready'?
A Transition into School document from Norfolk Children and Young People's Health Services lays out several skills considered important for children to have by the time they start school, including going to the toilet alone and cleaning themselves up afterwards, feeding themselves (including using cutlery and opening packaging) and putting their coat and shoes on.
It says expressing needs, thoughts and feelings "is just as important as reading and writing skills" and asks parents to consider whether their child can start a conversation, ask a question, follow instructions and make themselves understood by others.
In response to concerns from parents and teachers, the National Association of Head Teachers and the Family and Childcare Trust co-authored the School Ready? report in 2017, which questioned school leaders about children's fitness to start school.
Of those polled, 83pc reported an issue with school readiness. A quarter felt that more than 50pc of their intake at reception year were not school ready and most respondents felt the problem had become worse over the previous five years.
Two thirds (67pc) of respondents said one of the likely reasons children are not school ready is a failure to identify and support additional needs early enough, while almost as many (66pc) said parents had fewer resources available or more family-related pressures.
Paul Brooker, Ofsted's East of England director, said assessments of reception age children's development were showing steady improvements in Norfolk.
But despite this improvement and an increasing number of preschools and nurseries being judged good and outstanding, he said providers were picking up an increasing number of issues among their children.
He said: "We want children [in reception] to be ready to learn. At that age, not being able to do your shoe laces or your buttons up or go to the toilet unaided will delay a child's ability to learn.
"It also covers delays in communication, social and emotional developments and also in physical development, being able to do simple physical tasks such as using scissors or holding a pencil.
"If they cannot have some kind of fine motor control they will fall behind and we know from research and inspections that children who fall behind find it difficult to catch up."
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