The American Academy of Pediatrics (AAP) has come out strong in support of reading to kids, calling early literacy promotion an “essential component of primary care pediatric practice.”
In a June 2014 policy statement, the AAP recommends that all pediatricians advise families that reading aloud and talking about pictures and words with their young children has many benefits—increased language and vocabulary; reading readiness skills; enhanced brain development; and positive parent-child relationships. This means that parents should be talking and reading to their infants and toddlers even before children can talk.
As an educator with a background in reading, I have preached the importance of a language rich environment for infants and young children for years. I worked for 14 years with the Louisiana Department of Education providing instructional assistance to classroom teachers of young children with delays. More recently, I developed and supervised the Early Head Start program for high risk, low income children, birth to three, and their families in Caddo Parish.
When I supervised the Early Head Start program, two concepts provided a foundation for our program:
1) “It’s all about relationships.” We sought to promote the strong emotional bond between parent and child; to ensure positive relationships between the teachers and young students in our program; and to develop partnerships in the community in order to help our children and families succeed.
2) “Parents are the first and most important teachers of their children.” Our Early Head Start team provided quality center-based, year-round programming for our students, but we knew that the families were the key to the continued and future successes of Early Head Start students.
The AAP statement also stresses the relationship between child and parent, of the need to teach parents how best to support their children’s learning; and the policy encourages community partnerships—all directed toward promotion of shared reading experiences in the early childhood years.
Evidence Behind the Problem
The position of the AAP, and of early childhood programs for at-risk children, is based on evidence-based research from the field of early education. Betty Hart and Todd R. Risley’s research in the 1990’s found that children, between birth and age four, from low income homes hear much less talk (a restricted number and type of words) compared with children from middle income and higher literacy homes. The language the lower income children hear is too often directive language (“No,” “Stop that,” “Hush).” The low-income child also experiences fewer storybook routines.
Thus, the researchers calculated that by age four, children of poverty may have been exposed to 13 Million fewer words than children from working class families and 30 Million fewer words than children from language-rich, higher income homes. More recently, the 2011-2012 National Survey of Children’s Health found that only 60% of American children from birth to 5 years of age whose families make 400% of poverty level were read to daily, suggesting that many middle income young children also lack a language rich, print rich environment. Today many parents feel pressed for time and have come to rely on electronic media to entertain their children.
What Parents, Pediatricians Can Do
Pediatricians are in a unique position to promote the value of early literacy to parents and to demonstrate appropriate methods of shared storybook reading. Techniques to enhance the reading experience with young children can be modeled for families in the pediatric health setting. Adults may start out reading or singing nursery rhymes or simple songs to infants. As the baby gets older, the adult points to pictures in simple books and names objects for babies. Older infants will eventually point to pictures when asked and attempt to imitate the parent. The child will start to enjoy hearing the parent read a short predictable book or talk about the pictures in a familiar book.
However, young children may lose interest fairly quickly. Pediatric staff should emphasize to parents that this is normal and should be accepted by the parents. Reading with Mom, Dad, Grandma or Grandpa should first and foremost be a pleasurable experience, creating a warm bond of trust and comfort between child and adult.
The Five R’s
This AAP early literacy policy statement echoes an earlier AAP technical report on “School Readiness” in the promotion of the 5 R’s of early education:
- Reading together is encouraged as a daily fun family activity
- Rhyming, playing, talking, singing and cuddling together throughout the day promotes language development, as well as strong social-emotional bonds.
- Routines are important to young children–meals and bedtimes–because it makes their lives more predictable and it is easier for children to comprehend and know what is expected of them. This is why many children with problem behaviors rarely exhibit extreme behavioral issues in good early childhood classrooms. Once the child is enrolled in a structured, nurturing, and developmentally appropriate learning environment, he adjusts to and often welcomes the daily consistency. Moreover, experienced caregivers recognize that a certain amount of boundary testing is age appropriate and is a child’s way of asserting independence.
- Rewards for successes are important—recognition for the child’s making honest efforts toward common, age-appropriate goals like helping or kindness to others. Children love praise from the important adults in their lives. Praise should be specific, an acknowledgement that the child’s efforts are recognized. “You put your toys in on the shelf. Thank you for helping to keep your room clean and safe. I don’t want anyone to trip and fall over a toy.” “You let your sister ride your tricycle. That was a kind thing to do.”
- Relationships that are constant, consistent, positive, and purposeful lay the foundation for healthy early brain development and learning.
Pediatric offices are urged to identify economic ways to provide developmentally, culturally and linguistically appropriate books at well child visits for high-risk, low-income children. Displaying colorful posters, provision of simple written materials and sharing information about library programs and services is also helpful in getting the word out to parents.
The AAP recommends that pediatric providers partner with other child advocates to develop and support policies and programs that promote the goals described in the early literacy policy statement.
The Reach Out and Read program at LSUHSC, started in 1998, promotes early literacy by making books a routine part of pediatric primary care. Between 6,000 and 7,000 low-income children receive a book at each well-child visit from 6 months to 5 years of age. A volunteer reads to children once a month in the well-child waiting room.
Another source of free books for young children is Dolly Parton’s Imagination Library, currently available to families in select zip codes (71103, 71109, 71106, 71064, 71111) in Shreveport and Bossier thanks to sponsorship by United Way of Northwest Louisiana. Parents sign up on-line for their children to receive free books monthly from birth to age five.
The AAP provides a literacy toolkit for pediatric providers, educators and parents.