In the pediatric waiting room at the HOYA Clinic in Washington, D.C., there is a round, blue, child-size table with four chairs. Against the wall, between two large windows, stands a bookcase with four shelves of books.
This is where medical students read to the children of patients waiting to be seen by a doctor. Kids are also given these books to keep, free of charge, at every wellness visit with their pediatrician.
“We have volunteers in the pediatric room and they read to the patients’ children while they’re waiting to be seen by a doctor,” said Maggie Burke, a second-year medical student at Georgetown University’s School of Medicine and the Education Coordinator at the HOYA Clinic, a student-run facility that sees patients twice a week.
“Our clinic is located in the old D.C. General [Hospital] campus, and it’s now a homeless shelter for families. Most of our patients come from the shelter and they just don’t have a lot of resources, so this is a great opportunity for us to reach out to them with these books,” Burke explained.
The concept is part of a nationwide literacy initiative called Reach Out and Read, a non-profit organization that supports pediatricians to encourage parents to read to their children. At wellness visits for children ages 6 months to 5-years-old, doctors are giving out age-appropriate books to parents, and spreading the importance of interacting with their children to promote language development.
“I firmly believe that 0 to 5 has to be where we get children off to a healthy start,” said Earl Phalen, CEO of Reach Out and Read.
“All the research says that 96 percent of a child’s brain will be developed by the time they’re aged five…so the book really is the vehicle for the interaction of talking, playing together and bonding [between parents and children],” Phalen said.
The program was conceived in 1989 by a group of pediatricians and early childhood educators, at what is now Boston Medical Center. Reach Out and Read supplies children’s books to program participants, where doctors incorporate the development of a child’s language and interaction skills into the standard physical growth benchmarks that a child should attain by a certain age. At each wellness visit, parents are given a new age-appropriate book for their child.
To date, Reach Out and Read programs are available in over 4,700 clinics, private doctor’s offices and medical schools nationwide. In collaboration with Scholastic, last year they distributed 6.4 million books to 3.9 million children, according to their web site.
But what about the infomercials with toddlers reading 10-letter words or 4-year-olds reading Shakespeare? Phalen insists that this is not the goal of Reach Out and Read.
“It’s helping parents, many of who don’t know the importance of talking to, reading to and singing to their child as a way to stimulate their child,” Phalen said. “So it’s really about the stimulation and the interaction versus the rote memorizations.”
A Disturbing Trend in Literacy among Minority Children
Early childhood advocates believe that literacy should begin before a child enters a school setting. But not all parents have the resources or the know-how to lay the groundwork.
The National Institute for Literacy, in a short report to policymakers in 2009, stated that children who develop more literacy skills in the preschool years perform better in the primary grades.
Claudia Aristy saw her son’s interest in reading soar after she was introduced to the program by his pediatrician at Bellevue Hospital in New York. “At 6 months old, my son got his first book and he would put it in his mouth and tap on it and look at it,” Aristy said, who is now the Assistant Director of Children of Bellevue’s Reach Out and Reach where her son — now 14 — was seen as a toddler.
As he got older, and entered preschool, he was always attracted to the bookshelves in the classrooms.
“Once he started school in reading he always got his highest grades,” Aristy said.
But in order to get to this point, experts say it has to begin at home.
A 2001 analysis of early literacy skills in African-American children found that, “minority children and children who come from low-income households have consistently been identified as two groups who are at increased risk for academic failure because of differences or deficits in preschool literacy experiences, and language use or exposure.”
The report, published in Learning Disabilities Research and Practices, further questioned whether prevention programs for these children should begin earlier than kindergarten.
The report added that, “African-American parents increase their involvement in literacy activities once their children enter school, but failure to promote these activities prior to school entry places their children at a disadvantage compared to children from higher literacy homes.”
Aristy said that, being from the Dominican Republic, she didn’t grow up with books around her, but that when she was pregnant with her son she frequently visited the library, and became involved in parent-child programs at Bellevue. Now, through her work at Bellevue, she is able to encourage parents and see where she can help.
“Most of the parents that we see in our clinic did not grow up with reading aloud,” Aristy said.
Volunteers at the clinic aim to change that, and read to the children in the hope of showing these parents that reading is important.
“Just having a good time with your child enjoying a book, and in the process they’re learning.”
Dr. Veronnie Jones, a member of the American Academy of Pediatrics’ Committee on Early Childhood, believes the program goes beyond reading.
“It’s showing how to share books, to develop that relationship between the parent and the child,” Dr. Jones said. “It’s about opening that communication and using words with their child.”
Not All Programs Created Equal
Despite the success of Reach Out and Read, and the support it has received from early childhood advocates, there is a problem maintaining and sustaining the program’s success.
A 2009 study, published in the journal Pediatrics, looked at the differences in implementation of successful, moderate and unsuccessful Reach Out and Read programs in Baltimore, Md.
The study found that the reasons behind successful and poorly implemented programs included the cohesiveness of the staff, the work ethic of the staff, how adaptable the staff was to accepting new routines, and the pressures to meet financial obligations when more time might be needed with certain patients of the program.
The issue of poorly implemented programs is one that Earl Phalen is working to resolve.
“We know that there is a wide variation and that between programs there is high variance. Our work recently has been to say we have to provide enough support and incentives so that people really understand [what] makes [a successful program] work,” Phalen said.
Phalen also said that they recently received a grant from the Kellogg Foundation to conduct surveys in certain states, in order to check the effectiveness of Reach Out and Read.
But for Marie Reilly, a pediatric resident at Georgetown University, a successful program just takes commitment.
“It’s the uniformity of every visit, that you’re going to address this at every visit, and at the end you provide the child with a book. And it’s because there’s that consistency from visit to visit, that’s what helps us sustain this program.”