June 2014, VOLUME /ISSUE

Parents who read to their children nurture more than literary skills

  1. Lori O’Keefe, Correspondent

Reading proficiency by third grade is the most significant predictor of high school graduation and career success, yet two-thirds of U.S. third-graders lack competent reading skills. A new AAP policy statement recommends that pediatric providers advise parents of young children that reading aloud and talking about pictures and words in age-appropriate books can strengthen language skills, literacy development and parent-child relationships.

Literacy promotion during preventive visits has some of the strongest evidence-based support that it can make a difference in the lives of young children and families, said Pamela C. High, M.D., M.S., FAAP, lead author of Literacy Promotion: An Essential Component of Primary Care Pediatric Practice, http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2014-1384. The policy, released June 24, will be published in the August Pediatrics.

Promoting early literacy development in the pediatric primary care setting was a resolution at the 2008 AAP Annual Leadership Forum, leading to development of the policy statement. Dr. High is past chair of what now is the AAP Council on Early Childhood, which authored the policy.

Multiple benefits

Children who are read to during infancy and preschool years have better language skills when they start school and are more interested in reading, according to research highlighted in the statement. In addition, parents who spend time reading to their children create nurturing relationships, which is important for a child’s cognitive, language and social-emotional development.

“When I started with Reach Out and Read years ago, efforts were focused on early literacy and school readiness,” said Perri Klass, M.D., FAAP, national medical director of Reach Out and Read and contributing author to the policy statement. “Although those are still tremendously important, the bigger picture now is to help parents build interactions with their children into their everyday lives because this can create nurturing relationships, which promote early brain development, early literacy, language development and school readiness.”

Make it fun

An important job for pediatric providers is to help parents understand what is developmentally appropriate for their child and how to make reading fun, Dr. Klass said. “A parent shouldn’t read a long story to an infant or young child and expect them to listen attentively.”

Dr. Klass recommends parents point to and name pictures in books for infants and ask young children questions or have them complete rhymes from a short book.

Parents need to understand that 2-year-olds have a short attention span, and infants may put books in their mouths because that is how they explore their world, she said.

“We don’t want a parent to feel that their child is failing at reading if the child loses interest,” Dr. Klass added.

Powerful tool for all

Books also can be a useful tool during well-child visits.

Making books part of preventive visits allows pediatric providers to observe fine motor skills, language, literacy and parent-child interaction. Incorporating books into a visit also enables health care professionals to model book interaction with patients, according to the policy statement.

According to the 2011-’12 National Survey of Children’s Health, only 60% of children from families with incomes 400% above the poverty level and 34% of children from families below 100% of the poverty level are read to daily. Every family, regardless of income, should be counseled about the importance of reading together, said Dr. High.

The policy statement recommends providing books to patients who are at financial and social risk and exploring options to obtain books if they are cost-prohibitive.

The statement also recommends:

  • hanging posters that promote reading;

  • distributing information to parents about reading and local libraries;

  • partnering with child advocates to influence national messages and policies about literacy;

  • promoting the “5 R’s” of early education: reading, rhyming, routines, rewards and relationships;

  • incorporating literacy promotion and training into pediatric resident education;

  • supporting state and federal funding to distribute books to high-risk children at pediatric visits; and

  • researching the effects and best practices of literacy promotion.

“Books are a useful tool,” Dr. High said, “but we also want parents to understand that reading to their children is so powerful because children think their parents are the most important people in their world.”