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Introduction: Half of grade school-age children in the U.S. receive after school care from their grandparents or another adult family member. Yet, few studies have investigated if educating youth about stroke is an effective vehicle for spreading stroke knowledge to their families and the impact on onset-to-door time.Objective: To assess the level of knowledge about stroke warning signs and behavioral actions in school-aged children.Methods: Surveys differentiated to each school level- elementary (K-5), middle (6-8) and high school (9-12) - were administered to students in 3 community school districts. 6-8 and 9-12 grade students completed the surveys via an online tool, while K-5 students were guided through a picture-based survey. Topics included identifying the signs and symptoms of a stroke, risk factors for stroke and what action to take if the student thought someone was having a stroke.Results: Among 3 participating school districts, 3,425 elementary, 1,239 middle school and 1,594 high school students were surveyed. Less than half (43.7%) of K-5 students recognized 3 main signs of stroke (face, arm and speech). Stroke knowledge level is low among all students in elementary, middle and high school (Figure 1). Previous education was reported in 22% of K-5, 53% in 6-8 and 15% in 9-12 students. Those noting previous stroke education had increased knowledge at all 3 levels (p<0.001, p=0.002 and p<0.001). Total previous education occurring in school was reported at 11%.Conclusions: Children know how to respond to a medical emergency, yet their knowledge about the signs of a stroke is low. Educating youth increases their awareness regardless of age, making the student population a prime target for educational efforts. We plan to partner with school districts to develop curriculum appropriate for the elementary, middle and high school as the next step to increasing awareness about stroke.