קריאה לקריאה: ספרים כחלק מבריאות ילדינו

1. קריאה לקריאה:ספרים כחלק מבריאות ילדינו בועז פורטר

2. Early Brain Development • Every baby is born with a brain that is ready to learn • Early experience (interactions) shape the brain architecture needed for school learning • Early language skills are the foundation for later reading ability and are dependent on early language exposure

3. Brain Development

4. The Brain is the Ultimate use it or Lose it machine

6. National Assessment of Educational Progress (2000) • 37% of 4th graders perform below basic reading levels on national standardized tests for reading

7. השוואה בינלאומית בהבנת הנקרא: התלמידים הישראלים במקום נמוך הישגי תלמידי כיתות ד' בקריאה – השוואה בינ"ל (ממוצע עולמי- 500) ציון 561 שוודיה 1 הולנד 2 554 אנגליה 3 553 ארה"ב 9 542 גרמניה 11 539 סינגפור 15 528 רוסיה 16 528 צרפת 18 525 ישראל 23 509 טורקיה 28 449 מרוקו 34 350 מקום בליז 35 327

8. PROBLEM: Reading difficulty at school entry School problems (drugs, dropout, crime) Adults with low literacy and poor economic potential Damage to national economy

9. 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.

11. “Words heard on television and radio programs do not have the same impact as live, spoken conversation”

12. 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

13. Reach Out and Read Statistics • Founded in 1989 at Boston City Hospital • Over 2,300 sites • Over 24,000 providers trained • Over 2 million children from low-income families reached annually • Over 3.4 million books distributed per year

14. The Importance of aClinic-Based Intervention Medical Providers: • Reach most parents and children • 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

15. שלבים ברכישת קריאה: קריאה בוגרת שימוש ברמזים בדפוס חזרה על ספור מזיכרון חזרה על ספור מתמונות התעניינות בתוכן קריאה "כאילו" דפדוף בספר התעניינות בספר

16. Anticipatory Guidance:Picture Reading Skills • Points to pictures (8-12m) • Points when asked “Where?” (10-15m) • Names objects (16-24m) • Points and asks “What’s that?” (18-24m)

17. Anticipatory Guidance: Story Reading Skills • Book babble—sounds like reading (13-14m) • Fills in word in text (15-28m) • “Reads” to dolls or stuffed animals (17-25m) • Protests when adult gets word wrong (25-27m) • Child becomes teller of the story in response to questions (2-5 years) • Reads familiar books to self (30-36m)

18. Benefits of Reading Aloud Reading aloud to children: • Promotes physical contact and positive interactions • Stimulates imagination • Fosters language development • Enhances attention span • Encourages memory • Promotes reading skills

19. The Importance of Emerging Literacy (National Research Center, 1999) 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

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

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

22. Summary of research on ROR • 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 • Children participating in ROR tend to have increased language development in comparison to non-participating children

23. Illiteracy is a Big Problem.National Adult Literacy Survey (NALS), 1992 Representative sample of 26,000, age16 and up in “Real-life” literacy tasks: 40% of US adults scored in the lowest 2 levels (e.g. unable to understand newspaper story) Costs: productivity, shame, health

24. Health Costs of Illiteracy • 958 adults seen in urban ER took “Test of Functional Health Literacy” • Risk of hospitalization doubled in low-literate adults (32% v 15%) • After controlling for age, gender, race, SES, & health insurance, adjusted odds ratio still 1.7 (95% ci 1.1 to 2.5) Baker, et al (1998) J Gen Intern Med

25. Is Investment in Early Childhood Cost-Effective?

26. High Intervention effects and costs of social-emotional mental health problems over time (Bricker) Cost Intervention effectiveness Low Time

27. Rates of return to human development: Investment across all ages 8 Pre-school Programs 6 School Return Per $ Invested 4 R JobTraining 2 Pre-School School Post School 0 6 18 Age Pedro Carneiro, James Heckman, Human Capital Policy, 2003

28. LiteracyAs children move from year 3 to year 5, the disparity among those meeting literacy standards grows (Ainley J, 2001)

29. Results of Telephone Survey of ROR Participants

30. האם זו הקריאה הראשונה של ספר לילד?

31. תדירות קריאת ספרים לילד

32. “Anticipatory guidance for parents about sharing books with young children may be the only concrete activity of a pediatric provider that has been proven to promote child development.” • Barry Zuckerman,MD • Founding Director, Reach Out and Read

33. “My goal is that giving books will become as routine as immunizations…” Barry Zuckerman MD Chair of the Board and CEO, Reach Out and Read

34. Lessons for Implementation of ROR in Primary Care (Klass) • Change is easiest when grafted onto existing infrastructures • Change is easiest if its made easy • Change is more likely if the intervention is satisfying, well-received and fun • Change is most effective when the mission is well-defined and supported – ROR takes place in primary care settings

35. What are the challenges for ROR to succeed in Israel? • Committed, believing pediatricians • Research to back up beliefs • Partners: publishers, other health care workers, parents, medical students, community volunteers • Financial backing – major and minor sponsors

36. “What is the use of a book,” thought Alice, “without pictures or conversations?”Lewis Caroll-1865