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Reach Out and Read Improves Family and Child Health Outcomes through Primary Care

New article "The Elephant in the Clinic" examines the multifaceted role of Reach Out and Read in the promotion of early literacy and family well-being through primary healthcare.
Written by Nikki Shearman at 12:05

Closing the Achievement Gap Requires Interventions that Target Children from the Earliest Years

With the author's permission, this article is an adaptation of a letter to the editor of Pediatrics by Reach Out and Read Co-Founder Dr. Robert Needlman M.D., F.A.A.P. following the publication of the report Positive Parenting Practices, Health Disparities, and Developmental Progress

Reading aloud statistics

A new study published inPediatrics last month provides further evidence that economic disadvantage is associated with fewer stimulating early childhood experiences and increased risk of developmental delays. Working with data from 12,642 children 4 to 36 months of age, Shah and colleagues analyzed interactive parent practices, such as reading aloud, talking and playing, and showed that "less participation in interactive activities is associated with increased risk of development delay among those experiencing significant adversity."

This report confirms and builds on the message of the landmark Hart & Risley study, published 20 years ago that studied a total of 42 children intensely over 30 months, recording at intervals every word that was said to them, and every word they said in turn. These scientists found that by the age of four, children from lower-income families hear 30 million fewer words than their more affluent peers.

That these two disparate approaches reached the same conclusion is reassuring. That the underlying reality has remained unchanged for 20 years, that is, the propagation of social and developmental disadvantage, is not.

What has changed is the response to the problem. Both studies conclude that the achievement gap starts in infancy, and is already established by the age of four. Closing the achievement gap, therefore, depends on interventions that target children from the earliest days. Shah and colleagues go further to suggest that pediatricians have a vital role to play in delivering programs that strengthen parenting practices for the very young. "The advantages are that the primary care setting is established, non-stigmatizing, accessible locally, and has the potential to disseminate parenting interventions."

Reading aloud 2There are now many programs, both local and national, that seek to influence early childhood development, and several that operate through the primary care setting. Of the latter, Reach Out and Read is a well-established and successful non-profit organization - implemented in every state, in more than 5,500 clinics, and in virtually every pediatric training program. In fact, the American Academy of Pediatrics, that recommends "pediatric providers promote early literacy development" references Reach Out and Read as an effective intervention to engage parents and prepare children to achieve their potential.

Reach Out and Read was developed some 26 years ago and uses a simple time-honored model in which medical providers give books to children at each of their well-child checkups and encourage their parents to read aloud to them. It is supported by a large body of published research showing that the children we serve are read to more often by their parents, have improved language skills and a greater love of reading. Reach Out and Read now serves over 4.5 million children annually, including one in five disadvantaged children. We still have a long way to go, and we plan to continue to grow and reach more families and children across the nation, but as we contemplate how far we have yet to go in our efforts to combat social disadvantage, it's important to keep in mind how far we have come.


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Reach Out and Read National Center
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