Reach Out and Read National News

Boston Globe

Reaching out to create readers

April 10, 2005
Barry Zuckerman and Perri Klass

A 4-year-old boy sat in a pediatric exam room in a Boston neighborhood health center. He was worried about getting shots, but excited to tell his pediatrician that he would be starting kindergarten in the fall. ''And I get a book today, right?" he said, remembering past visits. ''I get a book to take home and keep!"

''He loves those books you give him," his mother said proudly. ''He wants me to read them all the time!" She thinks of the book as a friendly gesture from a kindly doctor, but it's actually a public policy intervention to promote school readiness.

This policy intervention addresses a major problem: One third of all children in this country are not ready when they enter school. They lack the basic language skills, which are usually acquired at home. In one study, investigators went into children's homes every month for two years, starting at age 8 months, and counted the words children heard in an hour. In professional families, children heard, on average, 2,150 words per hour, while children in working class families heard 1,250 words, and children in families receiving public assistance heard only 620 words. Since children learn language by what they hear; this correlated with vocabulary at age 3: The children from the families on public assistance had vocabularies averaging only 500 words, close to the cutoff for developmental delay. This compares to average vocabularies of 700 and 1,100 words respectively for the working class and professional class children.

If we find ways to help parents improve the language stimulation in the home, their children will more likely be ready for school and learning. Interventions need to start before age 3, and to reach those youngest children we need parents. The best activity to generate language and verbal stimulation is reading aloud, because it elicits more vocabulary and more complex sentences from parents than other activities, like feeding or bathing. This is supported by studies that show children who are read aloud to are more likely to enter school with greater language skills.

So how do we get parents to read aloud to their children? Reach Out and Read is a simple, cost-effective intervention in which pediatricians promote reading aloud at well-baby checkups. Reach Out and Read starts in infancy, with doctors giving age appropriate advice and encouragement, along with books. The program's goal is to expose young children to books and reading, helping them grow up in language-rich environments.

Research shows that Reach Out and Read is highly effective. Parents who participate are more likely to read to their children, and their children's language scores improve by 4 to 8 points-- a six-month gain for a 2-year-old. Part of the success is the messenger; because the books come from doctors, along with advice and guidance, they have more impact. Pediatricians also see children, including those most at risk, at early ages before other programs start.

The child in the story did get a book to take home and keep as he had since he was 6 months old. Each child gets approximately two books per year, and since the program is able to purchase high quality children's books at publishers' discounts, the average cost is $2.75 a book: approximately $5.50 per year per child. For each dollar spent, young children raise their language score 1 point. No other intervention gives that kind of bang for the buck.

In fact, the president and Congress have more than doubled the budget for Reach Out and Read for this coming year. Currently, Reach Out and Read has more than 2,300 programs in place in medical clinics and practices around the country, serving 2.5 million children with more than 3.5 million books given out each year. Because Massachusetts has been a leader in providing state funding to complement private and federal funding, there are 121 clinics, practices, and hospitals doing Reach Out and Read in Massachusetts, serving more than 115,000 at-risk children. We hope policy makers will include ongoing support for Reach Out and Read in this year's state budget. There is no better bargain for effectiveness, high value, and low cost. What better way to spend state money?

Dr. Barry Zuckerman is professor and chairman of the department of pediatrics at Boston University School of Medicine. Dr. Perri Klass is associate professor of pediatrics at Boston University School of Medicine.