Early Literacy in the Office: Reach Out and Read

1. Early Literacy in the Office: Reach Out and Read Wendy L. Hobson-Rohrer, MD, MSPH Associate Professor of Pediatrics Medical Director, ROR Utah

2. “Anticipatory guidance for parents about sharing books with young children may be the only concrete activity of a pediatric provider that has been proven topromote child development.” • Barry Zuckerman, MD • Founding Director, ROR

3. Objectives • Describe theReach Out and Read model of pediatric literacy promotion • Discuss importance of reading aloud • Discuss some research supporting Reach Out and Read • Explain how to become a Reach Out and Read site

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

5. Reach Out and Read Statistics • Founded in 1989 at Boston City Hospital by • Barry Zuckerman, MD, Robert Needlman, MD and Kathleen Fitzgerald Rice, MS Ed • Over 4100 sites • Over 50,000 providers trained • Over 3.5 million children reached annually • Over 5.4 million books distributed per year • Over 20 million books distributed overall

6. Endorsements • American Academy of Pediatrics • Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents • White House Conference on Global Literacy • 2007 UNESCO’s Confucius Prize for Literacy

8. Bear Lake CHC Cache Valley CHC Intermountain Budge Clinic U of U Stansbury Health Center McKay Dee Midtown CHC Pediatric Care of Ogden Hill Air Force Base • Central City CHC Copperview CHC • OquirrhView CHC Steven D. Ratcliffe CHC • Granger Medical Clinic South Main Clinic • U of U Pediatric Clinic 6 Cottonwood Pediatrics • Willowcreek Pediatrics Dr. Bob Terashima • St Mark’s Family Medicine Residency Program • Wasatch Homeless HealthCare - 4th St. Clinic • U of U Redwood U of U Westridge • Madsen Family Health Center Dinosaur Land Pediatrics Uintah Basin Medical Center Utah Navajo Health System: Montezuma Creek Clinic Montezuma Valley Clinic Blanding Family Practice Monument Valley Clinic Color Country Pediatrics • 34 ROR clinical locations • 41,026 children participate annually • 66,946 new books distributed annually Community Health Center of St George Enterprise Valley Medical Clinic

9. Three Components of Reach Out and Read • Medical providers encourage parents to read aloud and offer anticipatory guidance • At every health supervision visit, children aged 6 mos.- 5 years receive a new developmentally-appropriate book • Volunteers in waiting rooms read aloud to children

10. Reading Aloud and Children’sLiteracy Development(National Research Council, 1999) • Literacy development begins prior to reading • Early language and literacy experiences form the foundation for later reading and language competencies

11. Parental Language and Children’s Language • Children’s language evolves primarily through parent-child interactions • By two years of age, children’s language correlates with later cognitive performance

12. Reading Aloud and School Readiness(National Center for Educational Statistics, 1999)

13. Summary of ROR Research • ROR significantly and positively influences the literacy environment of children • Parents read more to their children • Parents and children have more positive attitudes toward reading aloud

14. Frequency of Reading Aloud (High et. al., 2000)

15. Attitudes Toward Reading(High et. al., 2000)

16. Summary of ROR Research • Shows that ROR is having direct effects on literacy development • Improving children's ability to express themselves verbally. • Increasing children's listening vocabularies. • Reducing the number of children with language delays that can prevent them from succeeding in school.

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

18. Why me? I already have enough to do. Medical Providers: • Have repeated one-on-one contact with families • Provide trusted guidance about children’s development • May serve as the only source of formalized support for poor families

19. The ROR Model 1) Books Given in Exam Room • At each health supervision visit, a child age 6 mos. - 5 years receives a new developmentally-appropriate book • Before kindergarten, a child receives 10 books • Books are introduced early in the visit and integrated into the examination within the context of other anticipatory guidance

20. The Book as Assessment Tool • Using the book to assess child development: • Fine motor development (maturity of grasp, hand skills) • Social/emotional interaction with others (shared attention, affect) • Cognitive skills (attention, memory) • Expressive and receptive language (vocabulary, comprehension of words) • Vehicle to offer parents concrete advice about child development

21. The ROR Model: Volunteers • Demonstrate reading aloud techniques • Show that reading is entertaining for children • Make waiting room experience more fun

22. The ROR Model 3) Anticipatory Guidance - Underscore reading aloud is important even before a child can talk - Stress that reading aloud is to promote the child’s love of books, not early reading - Emphasize reading is meant to be fun!

23. Who Benefits from ROR ? • Medical providers use books as valuable assessment tools and build bonds with families • Parents are given essential information about reading aloud and suggestions for parent-child interactions • Children get all the early literacy benefits of reading aloud and have 10 books of their own by age 5

24. How does my clinic become a ROR site? • Apply through www.reachoutandread.org • Budget calculation: • $2.75 per book x Number of WCC 6 mo - 5 yrs • Average peds practice: $7000 • Average family medicine practice: $2000 • Funding from Utah Coalition

25. Contacts:www.reachoutandread.orgreachoutandread.ut@gmail.com