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Early Literacy in the Office:
Reach Out and Read
Wendy L. Hobson-Rohrer, MD, MSPHAssociate Professor of Pediatrics
Medical Director, ROR Utah
“Anticipatory guidance for parents about sharing books with young children may be the only concrete activity of a pediatric provider that has been proven to promote child development.”
Barry Zuckerman, MD
Founding Director, ROR
Objectives
Describe the Reach Out and Read model of pediatric literacy promotion
Discuss importance of reading aloud
Discuss some research supporting Reach Out and Read
Explain how to become a Reach Out and Read site
The Mission of Reach Out and Read
To make literacy promotion a standard part of pediatric primary care, so that children grow up with books and a love of reading.
Reach Out and Read Statistics
Founded in 1989 at Boston City Hospital by – Barry Zuckerman, MD, Robert Needlman, MD
and Kathleen Fitzgerald Rice, MS Ed Over 4100 sites Over 50,000 providers trained Over 3.5 million children reached annually Over 5.4 million books distributed per year Over 20 million books distributed overall
Endorsements• American Academy of Pediatrics• Bright Futures Guidelines for
Health Supervision of Infants, Children and Adolescents
• White House Conference on Global Literacy
• 2007 UNESCO’s Confucius Prize for Literacy
Utah Navajo Health System:Montezuma Creek ClinicMontezuma Valley ClinicBlanding Family PracticeMonument Valley Clinic
Community Health Center of St George
Enterprise Valley Medical Clinic
Hill Air Force Base
Central City CHC Copperview CHC OquirrhView CHC Steven D. Ratcliffe CHC Granger Medical Clinic South Main ClinicU of U Pediatric Clinic 6 Cottonwood PediatricsWillowcreek Pediatrics Dr. Bob TerashimaSt Mark’s Family Medicine Residency ProgramWasatch Homeless HealthCare - 4th St. ClinicU of U Redwood U of U Westridge Madsen Family Health Center
Dinosaur Land PediatricsUintah Basin Medical Center
Color Country Pediatrics
U of U Stansbury Health Center
• 34 ROR clinical locations
• 41,026 children participate annually
• 66,946 new books distributed annually
Bear Lake CHC Cache Valley CHCIntermountain Budge Clinic
McKay Dee Midtown CHCPediatric Care of Ogden
Three Components of Reach Out and Read
Medical providers encourage parents to read aloud and offer anticipatory guidance
At every health supervision visit, children aged 6 mos.- 5 years receive a new developmentally-appropriate book
Volunteers in waiting rooms read aloud to children
Reading Aloud and Children’sLiteracy Development(National Research Council, 1999)
Literacy development begins prior to reading
Early language and literacy experiences form the foundation for later reading and language competencies
Parental Language and Children’s Language
Children’s language evolves primarily through parent-child interactions
By two years of age, children’s language correlates with later cognitive performance
Reading Aloud and School Readiness(National Center for Educational Statistics, 1999)
0
10
20
30
40
50
60
70
80
Pe
rce
nt
of
ch
ild
ren
Recognizeall letters
Count to 20 Write name Pretend toread/recite a
story
Have master3-4 skills
Less than 3 times
3 times or more
Summary of ROR Research
ROR significantly and positively influences the literacy environment of children
– Parents read more to their children
– Parents and children have more positive attitudes toward reading aloud
Frequency of Reading Aloud (High et. al., 2000)
0
2
4
6
Num
ber
of d
ays
and
nigh
ts
per
wee
k
Days/week Nights/week
Intervention
Control
Attitudes Toward Reading (High et. al., 2000)
0
10
20
30
40
50
60
Pe
rce
nta
ge
1 of 3 favoriteactivities of parents
1 of 3 favoriteactivities of children
Intervention
Control
Summary of ROR Research
• Shows that ROR is having direct effects on literacy development– Improving children's ability to express
themselves verbally.– Increasing children's listening vocabularies.– Reducing the number of children with
language delays that can prevent them from succeeding in school.
Children’s Expressive andReceptive Language Competencies(Mendelsohn et. al., 2001)
74
76
78
80
82
84
86
88
90
92
94
Vo
ca
bu
lary
sc
ore
s
Receptive language Expressive language
Intervention
Comparison
Why me? I already have enough to do.
Medical Providers:
– Have repeated one-on-one contact with families
– Provide trusted guidance about children’s development
– May serve as the only source of formalized support for poor families
The ROR Model 1) Books Given in Exam Room
– At each health supervision visit, a child age 6 mos. - 5 years receives a new developmentally-appropriate book
– Before kindergarten, a child receives 10 books
– Books are introduced early in the visit and integrated into the examination within the context of other anticipatory guidance
The Book as Assessment Tool Using the book to assess child
development:
– Fine motor development (maturity of grasp, hand skills)
– Social/emotional interaction with others (shared attention, affect)
– Cognitive skills (attention, memory)
– Expressive and receptive language (vocabulary, comprehension of words)
– Vehicle to offer parents concrete advice about child development
The ROR Model: Volunteers Demonstrate reading aloud techniques
Show that reading is entertaining for children
Make waiting room experience more fun
The ROR Model
3) Anticipatory Guidance
- Underscore reading aloud is important even before a child can talk
- Stress that reading aloud is to promote the child’s love of books, not early reading
- Emphasize reading is meant to be fun!
Who Benefits from ROR ? Medical providers use
books as valuable assessment tools and build bonds with families
Parents are given essential information about reading aloud and suggestions for parent-child interactions
Children get all the early literacy benefits of reading aloud and have 10 books of their own by age 5
How does my clinic become a ROR site?
• Apply through www.reachoutandread.org
• Budget calculation:– $2.75 per book x Number of WCC 6 mo - 5
yrs– Average peds practice: $7000– Average family medicine practice: $2000
• Funding from Utah Coalition
Contacts:www.reachoutandread.org
