Did you know babies are born learning?

1. Did you know babies are born learning? You can help your baby learn and it’s fun!

2. At birth a baby’s brain… • Contains 100 billion brain cells and is only a ¼ of the size of adults. It grows to about 80% of adult size by age 3 and 90% by age five • Is twice as active as an adult’s but not as efficient. • Looks like a road map. Some of the roads connect and intersect naturally while others begin to connect with stimulation

3. In the first years of your baby's life, the brain is busy building its wiring system. The amount of stimulation the baby receives has a direct effect on how many connections are formed. • Brain development continues our entire life but the development is never as rapid as it is in our first three years. • A three year old child’s brain cells have made most of their connections to other cells and over the next few years, connections will be refined again based on the child’s experience.

4. Babies learn using all 5 of their senses: Vision Hearing Taste Touch Smell

5. Vision • Vision is one of the least developed senses at birth. • Babies at birth see in the range of 10-15 inches, prefer black and white and sharp contrasts but most of all they enjoy looking at your face. in • By 4 months babies can distinguish color and by 10 months babies see as well as adults. • Babies are face learner. They learn by observing you and their surroundings.

6. Hearing • Babies’ hearing is tuned into adult speech and by 9-12 months the circuits are forming for different sounds. • Talking, reading aloud and explaining things to babies from birth builds on sound combinations needed for speech development • If more than one language is spoken in the home the baby’s brain will work efficiently to recognize the sounds of all languages heard on a regular basis. • By the time a baby is 1year old, he or she will have learned all the sounds needed to speak their native language • The more you read and talk to your baby the more words they are exposed to. Hearing words over and over helps to imprint them on a baby’s brain.

7. Taste and Touch Taste • Your baby will soon be exploring their surroundings by putting everything in their mouth, even books. Let your baby handle sturdy board books. This type of book can withstand chewing. Touch • Babies are very sensitive to touch. Skin to skin contact, gentle massage or stroking is very calming to a baby and actually helps forge connections in the brain. Early on grasping rattles, blankets, and even your finger will continue to stimulate connections as does holding and chewing books, toys and food will later on. • There are many types of books available for the very young: board books, touch and feel books like Pat the Bunny, fabric books, washable ones and even tough, indestructible ones. Let babies hold books as soon as they are able.

8. Smell • Smell is the most advanced sense of the five present in babies at the time of birth. It actually develops in the womb. • Babies seem to identify their mom's smell, right from birth and find comfort when this smell is near. As they get older they will show a preference towards sweet aromas such as vanilla or cinnamon. • There are a range of books on the market that are manufactured with different pages smelling like specific things, most commonly pleasant smells, like fruit.

9. Have fun being your baby’s first and most important teacher Play with words • In the early years “silence is not golden.” • Talk to or with your baby. Babies are pre- programmed to acquire language. • Babies need to hear language in their first year to speak it in the second. • Talk to and with your baby while changing, bathing or feeding. • Whisper to calm her. • Have a conversation with her. Ask a question and pause even though you know you will not get a reply early on.

10. Play time! Play with music: • Clap, dance and sway to the music. • Sing songs and lullabies to your baby even if you can’t carry a tune. They love the sound of your voice. Play rhyming games with your baby like…. • Itsy Bitsy Spider, This Little Piggy and Humpty Dumpty.

11. Read to your baby… From birth, try to read aloud to your baby a little bit every day.

12. Why Read? • To instill an early love of language and books. • To entertain and arouse your baby’s curiosity. • To introduce new sounds and words. • To lay the groundwork for language development. • To stimulate your baby’s brain. • Rhyme and repeat words are needed for learning. • To cuddle and comfort your baby. • To rediscover your own childhood favorites.

13. What to Read? • Focus on poetry, nursery rhymes, song and stories that have a refrain or chorus. • Ask friends, neighbors, teachers, family members, caregivers and healthcare workers to share some of their favorites. • Go to the library and borrow books for free. • Ask your parents what you liked as a child. • Ask at your local book store • Leave books in your diaper bag, different rooms, anywhere handy.

14. When and Where to read to your baby: anytime and anywhere! • Leave books in your diaper bag, different rooms, anywhere handy. • Read at bedtime or after a baby’s nap. • Read during cuddle time, whisper, and talk and make up stories. • Memorize rhymes and stories to tell in the car or out for a walk. • Most of all have fun!

15. Start having fun and reading to your baby today! • Inside the bag is a new book for you and your baby to enjoy together. • Fill out the enclosed card and we will send you two more free books, (1 at three months and 1 on your baby’s first birthday).You may mail the card or give it to a hospital staff member. • If you need additional free books for your baby or for your other children, visit www.readtogrow.org or call us at 203-488-6800. All books are free of charge for families. It’s never too early to start reading to your baby!

16. Words to Literacy • Children acquire about 860 words per year from age one to the end of second grade or about 2.4 words/day resulting in about 6000 words • Unfortunately the variability is significant: the bottom 25% avg only 1.6 words per day resulting in only 4000 words by the end of 2nd grade • Low income children are also much less likely to be exposed to new and unusual words compared with frequently used common words • A typical middle class child enters 1st grade having been read to for approx 1000 hrs compared with 25 hrs for low income children

17. Words to Literacy: Benefits of Reading Aloud • Children learn basic book skills: recognizing letters, understanding that print represents the spoken word, exposing children to story structure and literacy conventions such as syntax and grammar • Children learn phonological awareness: ability to manipulate the sounds of spoken language

18. Why Books and Literacy? • 1 in 5 children has significant difficulty learning to read. • Reading is to the mind what exercise is to the body. • Nationwide, only 47.8% of children are read to every day. • Incorporating books adds to efficiency in the exam room. • Reading/school success is linked to socio-economic status.

19. Income Matters • Children with reading challenges are disproportionately from low income homes. • Hart & Risley data: link between SES and early exposure to language. • NCES: link between SES and difficulty learning to read.

20. Hart and Risley Data

21. NCES Data 2003 % with Reading Difficulties (4th grade) f <185% poverty level >185% poverty level

22. What happens when children are not read to? Children at risk for reading difficulties are those who start school with: • lower verbal skills • less phonological awareness • less letter knowledge • less familiarity with the processes • of reading

23. Why Pediatric Clinicians? • Reach most parents and children and reach them early • Have repeated one-on-one contact with families • Serve as an important source of information and support • Provide trusted guidance about children’s development • Helps fulfill the goals of BRIGHT FUTURES in a time efficient and practical way!

24. The Impact of a Clinic-based Literacy Intervention on Language Development in Inner-City Preschool Children (Mendelsohn et. al., 2001) • Examined the impact of Reach Out and Read Program on children’s language development • 122 participants: 49 intervention, 73 control • Parents receiving intervention read to their child approximately one more day /week than those in control group • Children in the intervention had higher receptive and expressive language scores

25. Children’s Expressive and Receptive Language Competencies (Mendelsohn et. al., 2001)

26. Clinic-based Intervention to Promote Literacy (Needlman et. al., 1991) • A pilot study designed to determine if exposure to a clinic-based literacy intervention promotes parents’ reading aloud to children • Conducted waiting room interviews with 79 parents regarding children’s literacy orientation • Results indicated that parents who received a book were 4 times more likely to report reading to children.

27. Why Use/Give a Book? • Promoting health literacy is fast becoming the standard of care and helps keep your clinic current with practice trends. • Books provide an additional tool for evaluating development. • Children associate the provider with a fun book • Books helps build relationships…and it’s fun!

28. Early Toddler: 12-15 months Teachable moment: Books as an important part of family life and routines Bright Futures Guidelines Socio-Emotional • Hands you a book when he wants to hear a story; listens to a story • Has a strong attachment with parent or caregiver Communicative • Demonstrates protodeclarative pointing • Speaks 1-3 words • Jabbers with inflection of normal speech Cognitive • Follows simple directions

29. The adult helps the CHILD become the teller of the story. Dialogic Reading : Concept based on the writings of Dr. Grover Whitehurst of the Stony Brook Reading and Language Project.

30. Pre-Kindergarten Visit: 48-60 Months Teachable moment: The child who loves books is ready for school Bright Futures Guidelines Socio-Emotional • Social readiness to separate from parent easily and get along with other children Communicative • Clearly understandable with most speech efforts • Gives first and last name Cognitive • Knowledge of the alphabet, numbers • Curious!

31. Summary of Promoting Early Literacy

32. Read to Grow: why we do what we do • Birth is a teachable moment. • The brain develops at the most rapid pace in the first year • The book is a vehicle to promote bonding, closeness, and language development. • The number one reason parents do not read to their children is the lack of appropriate books.

33. Read to Grow’s Program • Provides a visit from a trained volunteer to parents with newborns • Provides books to babies and literacy information to their parents • We encourage parents to read to their children by providing books at 3 months and 12 months, a critical time of brain development • We provide more than 130,000 free, gently-used books to children and families who cannot afford them

34. Additional Program Details • Families receive a visit from a trained volunteer, a new book and our developmental guide • Read to Grow sends additional books at 3 months and 12 months along with more literacy information • The program is funded through grants and donations • For more information, visit www.readtogrow.org

35. Read to Grow’s Partner Hospitals 1999, Yale-New Haven Hospital becomes Read to Grow’s first partner hospital with 4200 births per year. Read to Grow now serves 53 percent of Connecticut newborns. Our partners are: Hospital of Saint Raphael Campus, Lawrence & Memorial Hospital, Saint Francis Hospital & Medical Center, Bridgeport Hospital, Manchester Hospital, St. Vincent’s Medical Center, Hartford Hospital, Sharon Hospital, Middlesex Hospital, Day Kimball Hospital, Griffin Hospital

36. The Mission of Reach Out and Read To make literacy promotion a standard part of pediatric primary care so that all children grow up with books and a love of reading.

37. Reach Out and Read’s Program • Reach Out and Read partners with pediatricians and primary care providers to prescribe new books to children and advice to parents about the importance of reading aloud. • Providers deliver our program in the exam room during well child visits for children from 6 months through five years of age. At each visit: • The child receives a new, developmentally appropriate book to take home and keep • The parent receives anticipatory guidance regarding early literacy and the importance of reading to their child • We focus on low-income populations where the children are at the highest risk for reading failure. • 15 peer review studies show that Reach Out and Read works!

38. Reach Out and Read’s Stats National Connecticut Partner with 61 hospitals and health centers Serve nearly 40,000 children and families Distribute more than 63,000 new, developmentally-appropriate books annually • Partner with more than 4,799 hospitals and health centers • Serve more than 3.9 million children and families • Distribute more than 6.4 million new, developmentally-appropriate books annually For more information, visit our website at www.reachoutandread.org or contact Christine Garber at christine.garber@reachoutandread.org

39. Questions??? Thank you!