Nationwide, millions of children are affected by a wide range of developmental challenges, including:

• sensory impairments (vision, hearing, tactile);
• attentional concerns;
• motor planning difficulties and mobility issues;
• developmental speech and language disorders (by some estimates as high as 19% of children);
• learning disabilities;
• autism spectrum disorders (1 in 100 to 150 children by 8 years of age); and
• intellectual disability (mental retardation).

Many of Reach Out and Read's Medical Champions either provide primary care to children with developmental disabilities or are specialists in this field. ROR can be a valuable way to promote literacy, specifically for these children and their families.

Too often, parents of children with disabilities underestimate their child's potential for developing literacy skills. ROR providers can help these parents make books and a love of reading part of their children's lives as well.

Reach Out and Read providers have found that the ROR model can be adapted for children with developmental disabilities. Providers have found that many components of the ROR intervention, including making reading an anticipated part of the daily routine (such as helping with transitions and introducing new situations to the child), creating literacy-rich environments, and encouraging joint attention, pointing, rhyming and singing, and sharing emotions, are particularly effective in promoting the literacy development of children with autism spectrum disorders.

ROR providers may find the following principles helpful, as they incorporate concepts of literacy acquisition into their anticipatory guidance for parents and caretakers of children with disabilities:

• Balance the demands of educational goals, therapies, and medical needs of the child with time for developmentally-appropriate activities of mutual pleasure that also promote literacy skills and joint and individual attention - reading together, storytelling, and playing interactive games.
• Encourage communication and literacy modeling and rich home learning environments.
• Acknowledge what parents are already doing with the child to promote early literacy.
• Direct parents to early intervention programs and disability-specific resources where they can learn how to engage their child in language, literacy, and play activities at home.
• Encourage adaptive approaches and tools to meet a child's specific needs (e.g. story boxes or tactile experience books for children with visual impairments, reading in standers, rhymes with stretching activities, positioning with reading to encourage joint attention).

Source: Monica H. Ultmann, M.D., Developmental-Behavioral Pediatrician and Director of the Center for Children with Special Needs and the Division of Developmental-Behavioral Pediatrics, The Floating Hospital for Children at Tufts Medical Center, Boston, MA.