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Aligning Reach Out and Read with Research

Extending our program to the first few months in accordance with research demonstrating the importance of the first few months to a child's foundation for success.

A guest blog from Teandra Ramos-Hardy, MSW, Director of Medical Engagement for Reach Out and Read Carolinas

Reach Out and Read in InfancyWe know from research that brains are built over time through a process that begins prenatally. The Center on the Developing Child at Harvard University has an abundance of research confirming that the foundation for all future learning is shaped by early experiences, beginning at birth.  A brain's architecture does not grow in isolation; it is developed by interactions with both genes and experiences.  The early years are the most active period for establishing neural connections in the brain.  The environment where one lives and grows, and the exchanges that take place with people in the environment shape the capacities that emerge in the early years.    

In the very first few weeks and months of life, milestones can be seen that reinforce the construct of brain architecture.  A newborn does not immediately have neck control, but a newborn's head gradually wobbles less in the weeks after birth.  One of the best times to observe this is during tummy time.  A newborn will also become responsive to sounds, especially their mother's or caregiver's voice.  They will become drawn to the voice and respond by focusing in the direction of the sound.  A newborn can also communicate by being quiet, cooing or babbling, and reaching.

The postnatal period is a critical time for newborn babies and mothers and many changes occur during this period. Although manuals are helpful, they are not provided at discharge from the hospital, and the web is overloaded with information that can easily overwhelm new parents.  The pediatric provider is the filter and support system a family needs to navigate through information they'll receive to care for their newborn.  Lack of appropriate care during this time can result in significant issues lasting into adulthood.  Newborns and mothers should be assessed at regular intervals following delivery. Further evaluation can be achieved through referrals from the healthcare provider as needed.  The American Academy of Pediatrics has developed a periodicity schedule that providers can follow to assess the health of the newborn, and the health and emotional well-being of the mother. 

The newborn checkup is an important medical visit for the provider to assess the health and development of the newborn following discharge from the hospital.  This initial visit with the healthcare provider allows the family to begin building a relationship with the provider and the medical home as important resources for them and their child - a partnership that lasts throughout the life of the child.  Although the newborn checkup is for the new patient, it is equally important to focus on how the entire family is adjusting to the new addition to the family.  This visit sets the expectation for the two-generational relationship that is created, and includes asking questions, addressing concerns, and providing parent education and anticipatory guidance.

Reach Out and Read Early YearsProviders spend time educating and giving anticipatory guidance to parents.  It has been found that books effectively increase maternal knowledge of anticipatory guidance material and encourage social and emotional bonding between parents and babies.  During well-child visits, parents are educated on many topics, and are likely to recall less of the information as more topics are covered.  Given the brevity of pediatric visits, providers can target behaviors like reading, talking, singing, cuddling, and bonding that are important. Embedding Reach Out and Read in the standard of medical care offers additional opportunities to encourage parent-infant reading, which influences parent-child interactions, children's language development, and future reading ability. The value of the intervention has been shown in lower maternal depression scores, and reports of maternal enjoyment of reading, and time spent reading with their children.  This is significant because the AAP supports maternal depression screenings per "Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice," beginning at the one-month well-child visit.

The research supports the value of starting Reach Out and Read in infancy.  Through this early literacy intervention, providers can support parents and impact children's lives from the beginning.  Here in Reach Out and Read Carolinas, we are joining with a National Reach Out and Read initiative to align with science and incorporate a zero to 6-month component of the Reach Out and Read program, encouraging our providers to talk with the pediatric patient and family about the importance of engaging with infants and sharing books in the first few months.  Research on the impact of this early intervention will continue to inform and guide our rollout across the country.

Written by Teandra Ramos-Hardy at 17:07

Positive Parenting Overcomes the Effects of Poverty on Brain Development

New research shows that positive parenting can overcome the effects of poverty on healthy brain development in adolescents.  In a report published in the Journal of the American Medical Association, Brody and colleagues described a neuroimaging study demonstrating that supportive parenting prevented the reduced growth of certain areas of the brain that occurred as a response to living in poverty.

Positive parenting and brain development

Numerous studies on the association of poverty with poor academic and psychosocial outcomes in childhood have pointed to the critical role of stress on brain development. Physical and social stress that often occurs during childhood in lower socioeconomic environments can influence the growth of the brain. In particular, there is evidence that development of the amygdala and hippocampus, brain regions that support learning, memory, mood and stress reactivity, is suppressed in disadvantaged children.

Brody et al conducted a neuroimaging study on 119 25-year-olds who had participated as adolescents in the Strong African American Families randomized trial (SAAF), a program designed to mitigate the negative effect of life stress on rural African American youths by encouraging positive parenting.  The intention of the study was to correlate the size of specific areas of the hippocampus and amygdala in these individuals, as determined by magnetic resonance imaging, with the number of years between the ages of 11 and 18 that they had lived under the federal poverty line. 

The results showed that, in the control population that had not been enrolled into the SAAF program, more time spent living in poverty was associated with smaller than average volume in areas of the amygdala and hippocampus. The good news was that this suppressive effect of poverty on brain maturation was prevented in those youths whose families had the benefit of the SAAF intervention. The promotion of positive parenting had conferred resilience to the stress of poverty. Importantly, this protective effect was detected at age 25 - it had lasted into adulthood. 

Interestingly, these positive results were achieved in a program serving the families of adolescent children. More than 95% of brain development occurs during the first six years of life, and the brain is particularly susceptible to the stress associated with poverty during this timeframe

Through the Reach Out and Read program, pediatric care providers are able to take advantage of their access to children during these early years. They encourage parents to spend time engaging with their young children through looking at books together starting in infancy,building the parent-child bonds that will alleviate the effects of adverse circumstances in the early years. 

This study encourages us that, through interventions that help parents to bring up their children in a positive, responsive way, it is possible to buffer against the consequences of poverty and low socioeconomic environments.  Leveling the playing field for disadvantaged children in this way can contribute to closing the achievement gap.

Written by Nikki Shearman at 08:32

Helping Children Understand, Discuss, and Process the Election Through Books

A booklist produced jointly by the American Academy of Pediatrics and Reach Out and Read

American Academy of Pediatrics Honors Dr. Perri Klass

Reach Out and Read National Medical Director, Dr Perri Klass, was honored for her "amazing impact on early childhood development" at the American Academy of Pediatrics National Conference in San Francisco last week.

perri awardDr. Benard Dreyer, President of the American Academy of Pediatrics, presented the Arnold P Gold Foundation Humanism and Medicine Award, which recognizes "an exceptional pediatrician, who not only demonstrates clinical expertise but the humanistic qualities of integrity, compassion, altruism, respect and service."  Dr. Klass was selected for this award by the Council on Communications and Media Pediatrics for the 21st Century planning group for her dedication to her profession and the health of children and the impact that she has made through her writing, service as an educator, and leadership in promoting early literacy through Reach Out and Read.perri1

Dr. Klass is Professor of Journalism and Pediatrics at New York University, where she is also Director of the Arthur L. Carter Journalism Institute. She is also well known as an author of several books and for parenting advice in her column, "The Checkup," in the New York Times. "Dr. Klass is a great clinician," said Dr. Dreyer "…. But she is most famous for being one of the originators of the Reach Out and Read program that so many of us [pediatricians] know is one of the major evidence-based programs in primary care. . . . she is now the National Medical Director, really spearheading the spread and the support and the quality improvement of Reach Out and Read."

 

 

perri2In receiving her award, Dr. Klass spoke around the theme of "What the doctor sees, is what the writer knows - we live in a world full of stories" and talked about how, through Reach Out and Read, pediatricians have worked together to change and enlarge the practice of pediatrics. "When we give these books to our young patients, when we encourage parents to read with them and trust in the power of that time together, the power of that interaction, that back and forth,…we can help children find their voices, write their own stories and that can change the world."

Reach Out and Read is proud to have Dr. Klass as our National Medical Director, and congratulates her on receiving this prestigious award from her peers and colleagues.

You can watch the full presentation of the award on YouTube.

Written by Reach Out and Read - Communications at 11:00

The Reach Out and Read Board of Directors Welcomes Two Influential Early Literacy Advocates

The Reach Out and Read Board of Directors is delighted to welcome two new members, Claudia Aristy and Evan Keyser. Claudia and Evan bring inspiring past experiences and individual perspectives to the Board that will support the organization's future growth and development.

Claudia Aristy has witnessed Reach Out and Read from every aspect of the program - first as a mother, then as a Parent Educator, and finally, as a Volunteer Trainer, and Director of the Reach Out and Read Program at Bellevue Hospital. These multiple roles give her a working knowledge and understanding of the Reach Out and Read model from the viewpoint of the families we serve.claudia-quote-background

As a mother inspired by the Reach Out and Read mission, Claudia went on to work as a bilingual Parent Educator in the Bellevue waiting room. She enjoyed spending her time directly in the clinic, speaking to parents about the importance of reading aloud and preparing them for the conversation that would take place later in the examination room with the pediatrician. "It is so grounding. All of us who have done this work - we would all agree - we do it for the children," says Claudia. 

Since 2013, Claudia has been Director of Children of Bellevue's Reach Out and Read Program and The HELP Project. In addition, Claudia serves on the Advisory Board of Leyendo Juntos, a Reach Out and Read initiative to support Latino families in their native language, and Reach Out and Read of Greater NY. Claudia is an inspiring mentor for new program site directors who have heard about Bellevue's continued success through Reach Out and Read.

"It's such an honor to hold this position," says Claudia. "I hope to bring the reality of everyday Reach Out and Read in the clinic. I have been on all ends of Reach Out and Read - I've been there as a mom, as a Parent Educator, a Trainer for Volunteers, and now a Director. I bring many different perspectives and I hope that will benefit the mission as a whole and hopefully inform some of the realities of the program."

 claudia-book

Evan Keyser's professional, extensive knowledge of finance will help to strengthen Reach Out and Read's organizational acumen as we continue to focus on strong and stable financial-management.

With over 9 years working in investment banking, Evan will support our strategic financial planning.

Supporting families and children has been a central theme of Evan's life. His mother taught orthopedically handicapped students in the Kansas City public school system and he frequently visited his mother's classroom and communicated with the students through reading and writing. Evan believes that these interactions helped to build a foundation for these students and was a wonderful way to connect with them on a personal level.

evan-quote-backgroundAs a volunteer for both Operation Breakthrough Kansas City and The Ronald McDonald House Kansas City, he has dedicated time to serving the lives of sick or needy children and to supporting their families, which helped to remove some of the burden associated with their situations.

"Throughout my formative years, I was surrounded by people and programs focused on helping children realize their full potentials through reading," Evan says. "Now, years later, I maintain the same desire to support the relationship between children and reading, albeit through a different lens, and am honored to contribute my views, abilities and experiences to further bolster the impact provided by Reach Out and Read."

Brian Gallagher, CEO of Reach Out and Read, says, "I am excited to welcome Claudia and Evan to our national Board of Directors.  Each brings a unique and critical perspective to our organization, and I know Reach Out and Read will benefit from the many contributions they will make in the coming years. "

Written by Reach Out and Read - Communications at 10:22

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