Where Great Stories Begin

News, Events, and Updates from Reach Out and Read

Bedtime Stories for Young Brains

NY Times article

Ed. Note: This guest article, written by Perri Klass, M.D., was originally posted in the New York Times on August 17, 2015. The original article can be viewed here.

A little more than a year ago, the American Academy of Pediatrics issued a policy statement saying that all pediatric primary care should include literacy promotion, starting at birth.

That means pediatricians taking care of infants and toddlers should routinely be advising parents about how important it is to read to even very young children. The policy statement, which I wrote with Dr. Pamela C. High, included a review of the extensive research on the links between growing up with books and reading aloud, and later language development and school success.

But while we know that reading to a young child is associated with good outcomes, there is only limited understanding of what the mechanism might be. Two new studies examine the unexpectedly complex interactions that happen when you put a small child on your lap and open a picture book.

This month, the journal Pediatrics published a study that used functional magnetic resonance imaging to study brain activity in 3-to 5-year-old children as they listened to age-appropriate stories. The researchers found differences in brain activation according to how much the children had been read to at home.

Children whose parents reported more reading at home and more books in the home showed significantly greater activation of brain areas in a region of the left hemisphere called the parietal-temporal-occipital association cortex. This brain area is "a watershed region, all about multisensory integration, integrating sound and then visual stimulation," said the lead author, Dr. John S. Hutton, a clinical research fellow at Cincinnati Children's Hospital Medical Center.

This region of the brain is known to be very active when older children read to themselves, but Dr. Hutton notes that it also lights up when younger children are hearing stories. What was especially novel was that children who were exposed to more books and home reading showed significantly more activity in the areas of the brain that process visual association, even though the child was in the scanner just listening to a story and could not see any pictures.

"When kids are hearing stories, they're imagining in their mind's eye when they hear the story," said Dr. Hutton. "For example, 'The frog jumped over the log.' I've seen a frog before, I've seen a log before, what does that look like?"

The different levels of brain activation, he said, suggest that children who have more practice in developing those visual images, as they look at picture books and listen to stories, may develop skills that will help them make images and stories out of words later on.

"It helps them understand what things look like, and may help them transition to books without pictures," he said. "It will help them later be better readers because they've developed that part of the brain that helps them see what is going on in the story."

Dr. Hutton speculated that the book may also be stimulating creativity in a way that cartoons and other screen-related entertainments may not.

"When we show them a video of a story, do we short circuit that process a little?" he asked. "Are we taking that job away from them? They're not having to imagine the story; it's just being fed to them."

We know that it is important that young children hear language, and that they need to hear it from people, not from screens. Unfortunately, there are serious disparities in how much language children hear - most famously demonstrated in a Kansas study that found poor children heard millions fewer words by age 3.

But it turns out that reading to - and with - young children may amplify the language they hear more than just talking. In August,Psychological Science reported on researchers who studied the language content of picture books. They put together a selection from teacher recommendations, Amazon best sellers, and other books that parents are likely to be reading at bedtime.

In comparing the language in books to the language used by parents talking to their children, the researchers found that the picture books contained more "unique word types."

"Books contain a more diverse set of words than child-directed speech," said the lead author, Jessica Montag, an assistant research psychologist at the University of California, Riverside. "This would suggest that children who are being read to by caregivers are hearing vocabulary words that kids who are not being read to are probably not hearing."

So reading picture books with young children may mean that they hear more words, while at the same time, their brains practice creating the images associated with those words - and with the more complex sentences and rhymes that make up even simple stories.

I have spent a great deal of my career working with Reach Out and Read, which works through medical providers to encourage parents to enjoy books with their infants, toddlers and preschoolers. This year, our 5,600 program sites will give away 6.8 million books (including many to children in poverty), along with guidance to more than 4.5 million children and their parents. (The group also provided some support to Dr. Hutton's research.)

Studies of Reach Out and Read show that participating parents read more and children's preschool vocabularies improve when parents read more. But even as someone who is already one of the choir, I am fascinated by the ways that new research is teasing out the complexity and the underlying mechanisms of something which can seem easy, natural and, well, simple. When we bring books and reading into checkups, we help parents interact with their children and help children learn.

"I think that we've learned that early reading is more than just a nice thing to do with kids," Dr. Hutton said. "It really does have a very important role to play in building brain networks that will serve children long-term as they transition from verbal to reading."

And as every parent who has read a bedtime story knows, this is all happening in the context of face-time, of skin-to-skin contact, of the hard-to-quantify but essential mix of security and comfort and ritual. It's what makes toddlers demand the same story over and over again, and it's the reason parents tear up (especially those of us with adult children) when we occasionally happen across a long-ago bedtime book.

 

Written by Perri Klass at 10:35

Reach Out and Read has a Prescription for Success

IMLS marquee

Ed. Note: This blog was originally posted by UpNext, the Official Blog of the Institute of Museum and Library Services. The original post can be viewed here.

Reach Out and Read is pleased to announce the launch of our Prescription for Success Toolkit, designed to support collaborations between libraries, museums, and Reach Out and Read program sites, natural partners that have a collective impact on the lives of young children. 

In January 2015, we embarked on a yearlong project, Prescription for Success, funded by the Institute of Museum and Library Services. The project is aimed at helping more families benefit from museum and library services that foster literacy development in young children. As a national nonprofit organization comprised of doctors, who promote early childhood literacy, Reach Out and Read has deep and broad relationships within the medical community. Prescription for Success has leveraged these connections to explore new ways doctors and their staffs can collaborate with museums and libraries.

Waiting_roomReach Out and Read is a nonprofit organization that gives books to children at pediatric checkups, and encourages families to read aloud to their infants and toddlers. For many of the low-income families that we serve, this is the first book in the home. Encouraging families to make use of local libraries and museums extends the impact of our program, giving them opportunities to read more books together, and to spend time enjoying library and museum activities. And library and museum staff can reinforce our message that engaging with young children through reading and playing together helps foster healthy brain development that gives them the best start in life.

Conversely, Reach Out and Read can further the special role that museums and libraries have in meeting the needs of America's youngest learners and their caregivers. With unparalleled access to young children through pediatric checkups, we are able to open the door to libraries and museums for many families, especially those struggling on a low-income, who might otherwise not know the value of these institutions.

IMLS_Rx_Pad The Prescription for Success Toolkit is a compilation of best practices learned from a survey of current state and local partnerships between Reach Out and Read, libraries, and museums. It provides ideas and resources for those who currently, or would like to, work together.

The toolkit encourages local libraries, museums, and Reach Out and Read program sites to open conversations with one another to explore common interests and learn about one another to build trust and community. It suggests ways they can support one another, such as clinics prescribing visits to the library using a prescription pad, libraries distributing Reach Out and Read materials or helping to create literacy-rich waiting rooms at Reach Out and Read clinics. Links to materials and resources and examples of successful established partnerships help with collaborations.

Written by Nikki Shearman at 12:00

Reach Out and Read Expands to Serve Infants from Birth to Six Months

Reach Out and Read doctors are starting to guide parents about the importance of talking, singing, reading and playing with their babies as early as the newborn checkup.

0-6 month 1Our organization has traditionally promoted the importance of reading aloud to children aged 6 months through 5 years. Reach Out and Read was founded in 1989 to take advantage of the unique opportunity that pediatricians have to affect the development, as well as the health, of the children they serve, especially those from low-income communities. A simple model was established of giving books to children and advice to families about the benefits of reading aloud together starting at the 6-month pediatric checkup. This reflected a tactical awareness that a 6-month old child can sit up on a parent's lap, and begin to grab and move the pages of a board book.

 However, advances in our understanding of early childhood development over the last 25 years have shown us that it is essential to encourage parents to engage with their infants right from birth. The first six months of life is a period of rapid brain development that does not occur at any other time, and is a critical window when parental responsiveness can shape a child's development (for more details, please read our previous blog post).  Accordingly, in 2014, the American Academy of Pediatrics released a policy statement recommending literacy promotion in primary care starting at birth.

In recognition of this, the Reach Out and Read leadership has announced a move to start the program earlier, such that it will now officially serve children from birth through 5 years.

"We believe that this will help us to do our job more effectively with families, bring us clearly into alignment with current scientific thought and best practices, and help us partner more effectively with other organizations in the field" explained Brian Gallagher, Executive Director of Reach Out and Read.

0-6 month 2

Reach Out and Read Medical Advisors have urged the 21,000 healthcare providers practicing the program to start recommending to parents the importance of talking, singing, reading and playing with their babies as early as the newborn visit. Materials, such as our popular Developmental Milestones chart, have been revised to reflect the change, and training will support the program expansion. 

"We are considering carefully and seriously how best to get guidance to parents during those complicated, joyous, and sometimes overwhelming months when they are learning to care for their new babies." said Perri Klass, Reach Out and Read National Medical Director. "We want Reach Out and Read providers to use those formative early visits in the most helpful, practical, developmentally appropriate, supportive ways, helping parents develop the responsive, positive, language-rich interactions, which should surround babies from the very beginning."

Written by Nikki Shearman at 09:00

Doctors Tell Us that Reach Out and Read Makes a Big Difference

We know that Reach Out and Read is an effective early literacy intervention from our extensive evidence base. Since its foundation, the Reach Out and Read model has been studied by a variety of academic investigators, providing an extensive body of peer-reviewed research on the effects of the program.  This shows that parents served by Reach Out and Read are up to four times more likely to read aloud to their children. Also, children served by Reach Out and Read score three to six months ahead of their non-Reach Out and Read peers on pre-school vocabulary tests.

Doctors Tell Us that Reach Out and Read Makes a Big Difference This analytical approach is compelling, but we also hear about how Reach Out and Read affects children's lives from the stories that our medical providers tell us. At the cutting edge of the program, they are able to put a human face on the Reach Out and Read story.

They see how excited infants and toddlers are to receive new books, especially in the low-income communities that Reach Out and Read often serves….

"I still am surprised when a family responds with "We don't have any books"! It is wonderful to see the smiles on the child's face when they take home their very own book!"

"The parents and children look forward to receiving books at their checkups. The children are eager to read out loud and look at the pictures. Sometimes this is the first and only time a child will receive a book."

"One little patient of mine had parents in the Military, who were going to be relocated across the country. His Mother told me that he was allowed to take one suitcase of "important things" - the rest would arrive in a week or two. He filled up half of his suitcase with his Reach Out and Read books!"

…How their guidance encourages parents to read to their children frequently……

 "We had given a book to a 6-month-old infant during the checkup. Mom said they did not have books at home. We talked about the importance of early literacy and a language-rich environment to help develop vocabulary and how it all affects brain development. Mom was very interested in what we talked about. But, when she noticed how intrigued baby was with the book, that was when she smiled and said "Maybe we need to get a couple more books because it seems that he likes them!""

…And, most importantly, how families reading together supports the healthy development of children in their care….

"Jayden was a 2-year-old when I first saw him. He was completely attached to his mom, made no eye contact, and spoke absolutely no words other than "mama" and "dada".  His mother was from a low-income background, going through a divorce, and said she could not afford evaluation or speech therapy. I spent about 30 minutes explaining the importance of reading aloud and having fun together. Slowly but surely Jayden showed progress, and at his last visit he came running to me, hugged me and said "Thank you Dr. K--" in a cute but intelligible way. I could understand close to 50% of all that he said, thanks to the Reach Out and Read books that I kept giving him every visit. Yes, books do make a difference, a big difference."

 

Written by Nikki Shearman at 10:45

The Importance of Encouraging Parents to Read Aloud to Their Young Children

There is a well documented and growing achievement gap between children growing up in the United States that starts in early childhood and persists through school and college into adulthood. It has become increasingly important to determine the factors that affect child development, both positively and negatively, so as to identify how we can give every child the opportunity to grow up into well-rounded adults. This is important for the future of our families, our communities and our nation.

Encouraging Parents to Read Aloud to Their Young Children

Advances in neuroscience technology over the last two decades have allowed us to chart human brain development. The evidence is still accumulating, but it is now well established that our brains develop most rapidly during the first few years of life. The brain has reached 95% of its full size by the age of six.1

Areas of the brain associated with specific skills develop sequentially - the sensory pathways develop first, followed by connections that result in language capability, followed by higher cognitive function. What is most significant is that maximal development for all functions occurs during the first five years of life.3

Child development studies have shown that the architecture of the early developing brain is influenced by a child's experience. Nurturing from a loving parent or caregiver stimulates the brain to develop the circuits that provide the foundation for emotional well-being, social competence and cognitive abilities. Conversely, adverse experiences prevent the brain from developing to its full capacity.

The best time to have an impact on children's achievement is during this critical window of early brain development, from birth through five years. And the best way of positively influencing early brain development is to strengthen the capacity of adults to nurture their children. Giving parents guidance about cuddling, talking to, and playing with their infants and toddlers will help them to support their child's development.

So, how do we reach parents of young children with this guidance?

This is where Reach Out and Read comes in! Our program is integrated into the pediatric healthcare system, so that we have repeated and unparalleled access to families with children from birth through five years at well-child checkups. Over 84% of children visit a pediatric healthcare provider during their first year.  By offering guidance about reading aloud to infants and toddlers, as a simple way of encouraging language-rich nurturing, our medical providers can help parents to give their children the best start in life.

1Lenroot, R.K. & Giedd, J.N Brain development in children and adolescents: Insights from anatomical magnetic resonance imaging. Neuroscience and Biobehavioral Reviews 30 (2006) 718-729 


 

Written by Nikki Shearman at 09:04

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