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
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
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
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
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
"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.)
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.