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Reach Out and Read
Reach Out and Read
Reach Out and Read
A Pediatric
Early Literacy
Program
Information Kit
This brochure has been published by the
Association of American Publishers' Trade
Division, with production support from Mosby
and Lindenmeyer Co.
Why Are Books
and Reading Aloud
So Important?
Research studies indicate
Reach Out and Read
that early positive exposure
to children's books,
Reach Out and Read
especially through reading
aloud, helps children learn
to read. The 1985 National
Commission on Reading
reported that children's
Reach Out and Read
experiences being read to
were the single most
important predictors of
later reading success.
Reading aloud supports
language and cognitive
A Pediatric Early
development. Favorite
Literacy Program
books may join teddy bears
and blankets as transitional
objects, easing separations
for children. Children can
Developed At
use stories to work through
Boston City Hospital
fears and problems. And
perhaps most importantly,
children begin to view
reading as a pleasurable
experience. A positive
books, she is going to be a reader. If she's
relationship with books
children enter school.
This brochure has been published by the
Association of American Publishers' Trade
Division, with production support from Mosby
Reach Out and Read
Boston City Hospital, Mat 5
"I know that by keeping her nose in the
818 Harrison Avenue
Boston, MA 02118
a reader, she could be a writer. She could
becomes critical when
be a doctor. She could be anything."
a Reach Out and Read parent
and Lindenmeyer Co.
What is the Reach
An Idea Flourishes
Out and Read (ROR)
How Does
Program?
In May, 1994, ROR received a major
ROR Work?
three year grant from the Annie E. Casey
Foundation to develop and implement
ROR
was created in 1989 by a group of
similar pediatric early literacy programs
pediatricians and educators in an effort
in health-care settings nationwide, with
to fight illiteracy in Boston's
Boston City Hospital as a national
impoverished communities. ROR
In the clinic waiting
training site. The Association of
improves literacy among children living
room, community
American Publishers is the publisher
in poverty by reaching them at an early
volunteers read stories to
of ROR's training materials.
age and providing parents with the
children and model reading
information, support and materials they
aloud techniques for
ROR
seeks to change the culture
need to make books a part of their
parents.
of pediatrics by making literacy
children's lives. ROR uses the power of a
development part of every child's
supportive relationship between parents
pediatric care. Programs are designed to
and health care providers to help
be co-directed by a multidisciplinary
children learn to read.
In the examining room,
team, and implemented in collaboration
the pediatrician or nurse
with local community organizations.
ROR
integrates parent education
practitioner gives an age
National pediatric and literacy advisory
about literacy development into regular
appropriate children's book
boards have been created by the national
pediatric care for children between the
to the child, comments on
training site in Boston to provide
ages of 6 months and 5 years, taking
the child's abilities and
guidance to the program on a national
advantage of regularly scheduled well-
scale.
counsels parents on how to
child visits to reach parents of young
use books to support their
children before the school system can.
Through the guidance from pediatricians
child's healthy development.
How To Become Involved
and nurse practitioners, parents learn
ways to support their children's early
literacy development. In addition,
At each visit, the child is
For more information about
children receive a free book at each
invited to take home a new,
ROR, please contact:
pediatric visit and share stories with
developmentally and
volunteer waiting room readers.
culturally appropriate
Reach Out & Read
A
children's book. Over time,
1991 pilot study by ROR found that
National Training Site
the child acquires a home
parents who had been given a book and
Boston City Hospital, Mat 5
literacy counseling during a clinic visit
library of books to share
818 Harrison Avenue
were four times more likely to choose
with family and friends.
Boston, MA 02118
book sharing as an activity with their
(617) 534-5701
child.
Boston Globe
For children's good health,
10/27/96
a book at every check-up
He came for a physical recently and we
PERRI KLASS
checked his lead level, since as a toddler
in the inner city he's at high risk, and
his week Boston will play host
checked for anemia. But he didn't seem
T
to the annual meeting of the
to have needles on his mind.
American Academy of Pediat-
"Want book!" he yelled to me with
rics, the professional organi-
2-year-old intensity. "Want book!" I
zation that speaks for pediatricians,
gave him a board book at his 18-month
tests us and certifies us, sets our stan-
visit (along with his fourth DTP shot),
dards of medical practice to keep up
another when he was 15 months (Hae-
with changing times.
mophilus influenzae shot) and another
But the pediatric innovation that my
when he was one year (measles-
collegues and I will be demonstrating at
mumps-rubella). And so on, way back to
the meeting, the Boston-bred innova-
the 6-month-old checkup. That's six
tion we hope will diffuse out through
books already; there'll be at least four
pediatric clinics around the country, has
more before he starts school.
nothing to do with wonder drugs or fi-
Reading success starts well before
ber-optic miracles. We want doctors to
school and formal reading instruction,
give books to their young
as infants and toddlers
patients.
learn to love books and to
'A decade ago, it
It's called
understand that books
wasn't part of a pediatri-
contain stories and infor-
'a light in the
cian's job to give out
mation. A 1995 analysis
books. But then. formal
darkness.'
that statistically exam-
assessments of develop-
ined 29 empirical studies
BOB DAHM ILLUSTRATION
ment and language
of the effects of parents
reading aloud to toddlers and pre-
and educators. "The first time I gave a
ert Needleman. carried out in the pedi-
weren't part of a pediatrician's role at
1-year-old a book as part of a pediatric
one time, either. Now we teach develop-
schoolers concluded that essentially all
atric clinic at Boston City Hospital. par-
visit and saw the child's eyes light up,
mental assessment as part of the stan-
studies showed a pronounced positive
ents whose child had received a book at
and saw the mother smile in response
dard pediatric exam. If. along with giv-
effect on outcome measures of language
a previous visit to the clinic were four
to her son's excitement, I knew I had
ing shots and handing out safety advice.
growth, emergent literacy and reading
times more likely to report reading
found a special way to touch a child's
we haven't checked to see if a child is
achievement. The positive effects of
aloud to their children. For families on
life." says Dr. Barry Zuckerman. chair-
acquiring spoken language. then we
reading to preschool children were in-
AFDC. the association was particularly
man of the department of pediatrics at
haven't done our job.
dependent of socioeconomic status or
Boston Medical Center and one of the
marked: if they had received a book.
The next step is written language.
parents' educational level.
founders of Reach Out and Read. "I be-
parents were eight times as likely to re-
Early literacy. Just as spoken language
Last week I saw a child I worry
lieve it has as much or more impact on
port reading to their children.
starts long before a child learns to talk.
about. He's one year old. born with
the child's future as anything I do as
Pediatricians are trained to think in
literacy starts developing long before a
drugs in his system. the youngest of six
part of preventive care."
terms of prevention. Give the MMR
child actually begins formal reading in-
children in a family that IS struggling
The goal of the program is to make
and we don't have to treat the measles.
struction. What happens in the years
hard. Mother in treatment. Maybe not
literacy part of regular pediatrics.
Free flu shots for children with asthma.
between birth and kindergarten is ab-
always enough food. Hasn't grown very
Zuckerman's mentor was Dr. T. Berry
Growing up without books is grow-
solutely essential: Children either start
well. Hasn't really developed on sched-
Brazelton, now a member of the adviso-
ing up deprived and with a deprivation
school liking books and understanding
ule. But he looked good. finally putting
ry board of Reach Out and Read. which
that puts one at risk for failure. Just
what they are or they start school way
on weight. making some developmental
he calls "a light in the darkness."
behind. set up for failure.
progress. though delayed for his age.
like many of the other risks and depri-
A book at every checkup from six
Mayor Thomas Menino's Read Bos-
[ gave him a board book full of
vations that children face in poverty.
months to five years. At Boston Medi-
ton literacy initiative. now one year old.
bright photographs of children playing.
growing up without books is a sad loss
cal Center. we will give away our
aims to have all children reading by the
and his mother and I watched him grab
100,000th book this fall. If it costs $3 to
in itself. but also a risk factor for larger.
end of third grade. Pediatricians and
it. "I know you're busy." I started. and
S4 for a book. and if every child sees the
sadder losses. Double jeopardy. If we
early-childhood educators have been
she beamed. "The older ones will read it
doctor 10 times between the ages of 6
want our children to grow up reading.
part of this initiative from the begin-
to him." she said. "They always read
months and 5 years. then these books
we have to do everything possible. and
ning because this is not only a school
him that book you gave him last time."
cost $30 to $40 a child. Less than any
we have to do it as early as possible.
problem. it's a preschool problem.
The Reach Out and Read program
immunization or blood test.
Consider my 2-year-old patient.
was founded at Boston City Hospital
In a study by Zuckerman and an-
Peint Klass is " pediatrican at Boston
Jahmaal. a primary-care success story:
about eight years ago by pediatricians
other founder of the program. Dr. Rob-
Medical Center and Dorchester House.
USA TODAY WEDNESDAY, JANUARY 29, 1997 7D
EDUCATION
To raise literate kids, plant seeds of reading early
By Beth Ashley
USA TODAY
A checklist for skills
Nothing prepares a kid better for
reading than being read to, experts
To help parents understand
unfamiliar words by sounding out
say.
children's reading progress, the
new words when reading aloud,
"The single most important thing a
Council for Educational Develop-
using context such as looking at
parent can do to help a child learn to
ment and Research (CEDAR)
the whole sentence and surround-
read is to read to the child early and
has outlined checkpoints. They
ing sentences, using phonics and
often - and I mean early, a few
are not an item-specific recipe for
using reference materials.
months old," says Banita Somerfield
every child but highlight skills
Reads a variety of texts, such
of the Barbara Bush Foundation for
that develop naturally. The child:
as
social studies, math and sci-
Family Literacy.
ence, as well as the local newspa-
In kindergarten
Finding time to read may be
per and popular magazines.
tough, but parents across America
Knows print carries meaning
Summarizes information
are doing their best: Shari Thompson
by turning pages in a storybook to
from
what has been read by ex-
of St. Paul Park, Minn., says she read
find out what happens next.
plaining what happened in a book
to her child, Jessica, even before Jes-
Knows what written lan-
or story, what makes the main
sica was born. "I was told that even
guage looks like by recognizing
character tick and the author's
in utero a baby can hear your voice."
that words are combinations of
reason for writing it.
A Yankelovich Partners study in
letters and identifying specific let-
Understands how the ele-
November said that 80% of parents
ters in unfamiliar words.
ments and characteristics of liter-
believe reading to their children en-
Identifies and names letters
ature interact by distinguishing
hances educational development.
of
the alphabet by saying the al-
whether an author is writing in
Half said they read to their children
phabet and pointing out letters of
the first or third person.
daily, if only for 20 minutes.
the alphabet in a text.
"Parents are doing a pretty good
Knows how books work by
In ninth grade
job," says reading expert Linda
holding them right side up, read-
Uses decoding and ;compre-
Gambrell of the University of Mary-
ing from left to right and top to
hension strategies to get informa-
land.
bottom and beginning at the front
tion from a wide range of materi-
The Yankelovich survey also
and moving to the back.
als - textbooks, classic novels
found that single parents tend to
such as Great Expectations and
read to their children more often
In third grade
To Kill a Mockingbird, and maga-
than two-parent households. "A sin-
Improves comprehension
zines such as Time and Psycholo-
gle mother spends time with her chil-
while reading a variety of simple
gy Today.
dren that she would otherwise spend
texts by thinking about what is
Demonstrates reading com-
with her spouse," Thompson says.
By Shawn Henry
known and asking and answering
prehension by explaining a char-
Ruth Graves of Reading Is Funda-
Brain medicine: Kids should learn to like books, says Perri Klass of Boston Medical Center's Reach Out and Read, which
questions while reading.
acter's traits, motivation and ac-
mental (RIF), which serves 3.8 mil-
prescribes books for poor kids. 'You have to see (books) as places to go for pleasure as well as information.'
Applies word-analysis skills
tions in the story, the theme and
lion children nationwide, says par-
while reading by using phonics
message or moral of a book.
ents need support from "the whole
getting kids to read, Somerfield says.
fects everything."
Reach Out and Read program began
and simple context clues to figure
village" if children are to learn to
And "parents who read at home are
If families are too busy for reading
when pediatricians wanted some
out unknown words and using
In 12th grade
read. She praises companies like
models for their children. 'If
time, "it's important to turn off the
way to help poor children who had
word parts - root words, prefix-
Reads a variety of texts on a
UGI Corp. in Pennsylvania, which
Mommy or Daddy reads, this must
TV," Melchior says. "Even if the kids
few, if any, books at home. Now the
es, suffixes and similar words.
number of subjects to build
sponsors RIF programs in schools,
be a good thing to do.''
aren't reading, they can find some-
pediatricians prescribe parental
Understands elements of lit-
knowledge and skills, conducting
and Nestlé in California, which has
"You walk into my house, every-
thing else to do besides TV, which is
reading as part of their treatment of
erature - author, main charac-
research on issues of personal in-
"adopted" 100 RIF schools. Employ-
one has a book," says Marie Knight,
the worst thing that ever happened
the children and send a book home
ter, setting - by coming to a con-
terest, asking questions as the stu-
ees of both volunteer to read to kids.
34, of Detroit, single mother of three.
to reading."
each time a child comes in.
clusion about events, characters
dent ponders the issues, and mak-
"It would be helpful if more busi-
"I keep a book in my purse."
Susan Neuman of Temple Univer-
"The doctors realized that kids in
and settings in stories.
ing connections between new
nesses recognized that employees
A reader since childhood - "you
sity says two to four hours a day of
poverty lag way behind developmen-
Understands the characteris-
information and personal experi-
have lives outside their employment,
can live in another country with a
TV help with literacy - "a television
tally in their ability to listen to sto-
tics of various simple genres -
ences.
and that being family-friendly is not
book" - Knight reads to her chil-
set is a word machine" - but more
ries, to sequence what happens and
fables, realistic fiction, folk tales,
Demonstrates aesthetic ap-
only good for the country but good
dren every day. "I just make the
is detrimental, "symbolic of a lack of
even to learn to turn pages," says
poetry and humorous stories.
preciation of reading materials
for the company."
time, because it's something I like to
other activities in the household."
medical director Perri Klass.
Uses correct and appropriate
by commenting on the language,
Three times a year, RIF lets kids
do." Her youngest daughter has been
Paul Andrews, an Austin, Texas,
Sometimes parents themselves
language conventions when re-
including the rhythm and rhyme
in schools, libraries, hospitals, day
able to read since preschool.
bookkeeper, not only reads to his two
can't read, Klass says, but pediatri-
sponding to text by correctly
of the text, critically evaluating
care centers and Head Start pro-
Lynn Melchior, also of St. Paul
children but finds time (often vaca-
cians encourage them to "look at the
spelling common words, using
texts in regard to their plots,
grams pick out a book to take home
Park, says reading aloud doesn't al-
tion time) to read in schools where
book with their child and make up a
capital letters and punctuation
themes, character traits, motives
and keep, no strings attached.
ways guarantee children will be-
most of the kids are poor.
story to fit it."
correctly, using appropriate and
and the effect of the setting on the
Gambrell says "children should
come good readers: Two of hers
To lure them to read, he and other
To learn to read, "you have to like
varied word choice and using
characters and the plot.
have lots of books. The way we in-
read avidly, the middle one "strug-
volunteers read snips of books, por-
books," Klass says. "You have to see
complete sentences.
crease the time children read is if
gles every day." If kids flounder, she
them as places to go for pleasure as
Free copies are available from
tray a story character or get (for ex-
they have books at home."
says, parents should take charge.
ample) a firefighter to explain how
well as information. If not, when you
In sixth grade
CEDAR, 2000 L St. N.W., Suite
Having books, magazines and
"We are working with a reading spe-
important it is to do well in reading.
get to school, books will have no
Uses strategies to figure out
601, Washington, D.C. 20036, 202-
223-1593.
newspapers at hand is a big factor in
cialist. If you're a poor reader, it af-
At the Boston Medical Center, the
point!"
EDUC
To raise literate kids, pla
By Beth Ashley
USA TODAY
Nothing prepares a kid better for
reading than being read to, experts
say.
"The single most important thing a
parent can do to help a child learn to
read is to read to the child early and
often - and I mean early, a few
months old," says Banita Somerfield
of the Barbara Bush Foundation for
Family Literacy.
Finding time to read may be
tough, but parents across America
are doing their best: Shari Thompson
of St. Paul Park, Minn., says she read
to her child, Jessica, even before Jes-
sica was born. "I was told that even
in utero a baby can hear your voice."
A Yankelovich Partners study in
November said that 80% of parents
believe reading to their children en-
hances educational development.
Half said they read to their children
daily, if only for 20 minutes.
"Parents are doing a pretty good
job," says reading expert Linda
Gambrell of the University of Mary-
land.
The Yankelovich survey also
found that single parents tend to
read to their children more often
than two-parent households. "A sin-
gle mother spends time with her chil-
dren that she would otherwise spend
with her spouse," Thompson says.
Ruth Graves of Reading Is Funda-
Brain medicine: Kids should learn to like books, says Perri Klass of Boston M
mental (RIF), which serves 3.8 mil-
'prescribes' books for poor kids. 'You have to see (books) as places to go to
lion children nationwide, says par-
ents need support from "the whole
getting kids to read, Somerfield says.
fects everything."
village" if children are to learn to
And "parents who read at home are
If families are too busy for readi
read. She praises companies like
models for their children. 'If
time, "it's important to turn off t]
UGI Corp. in Pennsylvania, which
Mommy or Daddy reads, this must
TV," Melchior says. "Even if the ki
sponsors RIF programs in schools,
be a good thing to do.' "
aren't reading, they can find som
and Nestlé in California, which has
"You walk into my house, every-
thing else to do besides TV, which
"adopted" 100 RIF schools. Employ-
one has a book," says Marie Knight,
the worst thing that ever happen
ees of both volunteer to read to kids.
34, of Detroit, single mother of three.
to reading."
"It would be helpful if more busi-
"I keep a book in my purse."
Susan Neuman of Temple Unive
nesses recognized that employees
A reader since childhood - "you
sity says two to four hours a day
have lives outside their employment,
can live in another country with a
TV help with literacy - "a televisi
and that being family-friendly is not
book" - Knight reads to her chil-
set is a word machine" - but mo
only good for the country but good
dren every day. "I just make the
is detrimental, "symbolic of a lack
for the company."
time, because it's something I like to
other activities in the household."
Three times a year, RIF lets kids
do." Her youngest daughter has been
Paul Andrews, an Austin, Tex:
in schools, libraries, hospitals, day
able to read since preschool.
bookkeeper, not only reads to his tv
care centers and Head Start pro-
Lynn Melchior, also of St. Paul
children but finds time (often vac
grams pick out a book to take home
Park, says reading aloud doesn't al-
tion time) to read in schools whe
and keep, no strings attached.
ways guarantee children will be-
most of the kids are poor.
Gambrell says "children should
come good readers: Two of hers
To lure them to read, he and oth
have lots of books. The way we in-
read avidly, the middle one "strug-
volunteers read snips of books, p
crease the time children read is if
gles every day." If kids flounder, she
tray a story character or get (for €
they have books at home."
says, parents should take charge.
ample) a firefighter to explain h
Having books, magazines and
"We are working with a reading spe-
important it is to do well in readir
newspapers at hand is a big factor in
cialist. If you're a poor reader, it af-
At the Boston Medical Center, t
HEALTH NEWS
A "Prescription' to Stimulate Young Minds
Success of Reading Encouragement Program at Boston Clinic Leads Other Hospitals to Follow Suit
By Kevin McManus
Washington Post Staff Writer
t looks rather innocuous, the little pad carried by doctors
I
in the pediatric clinic at St. Agnes Hospital in Baltimore.
"PRESCRIPTION FOR READING," each sheet says, and
below, in the space where a doctor might scribble
something about medicine, there is the printed instruction,
"Share a book with Your Child." Following that are two
options: "Every night at bedtime" and "For minutes a
day." It has the feel of a sweet, but humorous prescription.
To the doctors who sign and distribute them, though, these
prescriptions are serious business. Since last August, St.
Agnes has been taking part in a literacy program targeting
very young children and their parents who might not spend
time with books on their own. The program, organized by a
Boston-based group called Reach Out and Read, consists of
three elements: volunteers reading to children in clinic
waiting rooms, pediatricians urging parents to read to kids at
home and youngsters helping themselves to free books.
St. Agnes is one of 71 sites in 31 states where the reading
program has taken root.
"The earlier you expose a child to reading, the better he's
able to process reading," says pediatrician Kenneth Koski-
nen, pausing for a breather on a busy morning at St. Agnes.
"It's almost like you turn the computer on earlier, the
computer is smarter and is able to process the information
faster and better as the child gets older."
For some new parents, of course, the reading-aloud habit
arises naturally and irresistibly. But among many families in
the low-income population served by St. Agnes, Koskinen
says, the habit needs to be introduced and pushed-because
books cost money, because parents are busy and sometimes
because parents lack confidence in their own literacy. "The
majority of the patients that we see are on medical assis-
tance," Koskinen says, "and the environment from which
these people come is not necessarily optimal for learning."
After a doctor hands a reading prescription to a parent, the
child is invited to select a take-home prize from a set of
bookshelves near the nurses' station. "Our most popular
books are the ones for infancy to 2 years, because that's when
we see the children the most," says nurse Roberta Poulton as
she shows off shelves packed tightly with donated books.
BY GERALD MARTINE THE WASHINGTON POSi
Once selected, a volume is fitted with a bookplate bearing
Paul Cattle volunteers at St. Agnes Hospital to read to children because he says it is fun "sharing in their fantasy
the child's name. During the past six months, Poulton says,
adventures through books." His audience here is, from left, Brianna Crenshaw, Taylor Gable and Bilal Iqbal.
many kids apparently have come to associate the clinic with
free books: They're quick to ask for one whenever they visit.
and blankets as transitional objects, easing the separation at
Zuckerman says kids in the program are being studied now,
Down the hall from the bookshelves, in a waiting room,
bedtime. Children also use stories to satisfy desires vicariously
"but we don't have any data yet." Then again, he doesn't feel he
volunteer Eula Gray finishes reading a story to a little boy. He
and to work through their fears and problems."
needs hard data to sell the concept of early literacy, which holds
slips quietly from his seat, takes his mom's hand and heads
Youngsters who've formed these emotional ties before age 1
tremendous appeal for many book-loving adults.
for his checkup. Gray begins bundling up for the outdoors.
probably enjoy a huge advantage over kids who know nothing of
She has completed her shift here-two hours of open books
One of those adults is Perri Klass, a Boston Medical Center
books until they start alphabet studies in kindergarten, Needlman
and eager listeners-and she is happy.
pediatrician and writer who is Reach Out and Read's medical
and Zuckerman say. "When reading is presented as a set of
"I used to be a teacher, and I know how important it is for
director.
cognitive tasks that are unconnected to the child's basic
children to listen to reading from the very earliest ages," Gray
Klass says, "There are a limited number of things that I actually
interests," the coauthors write, "children who are not already
says. "It gives them a real sense of reading." She too gets
strongly motivated to read may see it as an empty exercise or,
give parents." Among the "life and death" items she strongly
something from the exercise: "My children are all grown, and
worse, a form of slow torture."
urges parents to get are medicines, bike helmets, car safety seats
I miss having someone to read to."
Most parents appear glad to have their kids entertained by
It was in 1990 that Needlman and Zuckerman first shaped
and window guards. "And I think that when you hand over a book,
storytellers, Gray says. But occasionally there is tension, as
these ideas into a public program. The catalyst was a conversation
it puts the book in that category: I don't want your child to grow
when one mother told Gray it made no sense to read to an
about visitors taking books from a waiting room at Boston City
up without this."
infant, since infants don't understand words.
Hospital, where the two men then worked. Zuckerman recalls
Another bibliophile who is sold on the program is First Lady
saying something like, "Maybe that's a good place for the books
Hillary Rodham Clinton, who last week plugged Reach Out and
"But then I saw [the mother] the next month," Gray says,
Read (without mentioning it by name) in a Time magazine essay.
"and she told me, believe it or not, that she had decided to do
to be-at home with kids."
so. And she felt the baby had responded to her voice."
The doctors aimed to capitalize on the special relationship
Washington's first Reach Out and Read program may begin as
Experts say a parent's voice is just one of several powerful
between a parent and a pediatrician. They figured that prescrip-
early as May at Children's National Medical Center. Sandra
stimuli for a baby. In a 1992 article in Contemporary
tions of daily reading would stand a good chance of being acted
Cuzzi, the pediatrician who's setting it up, says she has a $3,000
Pediatrics, Robert Needlman and Barry Zuckerman, CO-
upon because of parents' respect for doctors.
grant and needs about $12,000 more to buy books for the first
POST HEALTH COROANT 1391
founders of the reading program, described what they believe
The only evaluation of the program has focused on mothers in
year at the hospital's General Pediatric Ambulatory Center.
happens when parents read aloud to kids, early and often:
the Boston City Hospital program: Zuckerman says it found that
"Most of the parents that I speak with now, when I discuss
"Children
learn to associate books with their parents' love
these women were four times more likely to read aloud to their
reading with them, they don't have children's books at home,"
and attention. They have an emotional tie to the books, founded in
children than mothers from similar socioeconomic backgrounds
Cuzzi says. "That's not a priority. So I hope that by making that a
their earliest relationships. Favorite books may join teddy bears
who hadn't taken part in the program.
presence in the home, it will become important."
9
HEALTH NEWS
A 'Prescription' to Stimulate Young Minds
Success of Reading Encouragement Program at Boston Clinic Leads Other Hospitals to Follow Suit
By Kevin McManus
Washington Post Staff Writer
t looks rather innocuous, the little pad carried by doctors
I
in the pediatric clinic at St. Agnes Hospital in Baltimore.
"PRESCRIPTION FOR READING," each sheet says, and
below, in the space where a doctor might scribble
something about medicine, there is the printed instruction,
"Share a book with Your Child." Following that are two
options: "Every night at bedtime" and "For
minutes a
day." It has the feel of a sweet, but humorous prescription.
To the doctors who sign and distribute them, though, these
prescriptions are serious business. Since last August, St.
Agnes has been taking part in a literacy program targeting
very young children and their parents who might not spend
time with books on their own. The program, organized by a
Boston-based group called Reach Out and Read, consists of
three elements: volunteers reading to children in clinic
waiting rooms, pediatricians urging parents to read to kids at
home and youngsters helping themselves to free books.
St. Agnes is one of 71 sites in 31 states where the reading
program has taken root.
"The earlier you expose a child to reading, the better he's
Philadelphia Inquirer - salurday 9/7/96
Children's Hospital prescribes a dose of reading
Reach Out and Read provides books to
children. They provide the enthusiasm.
By Stacey Burling
her present from the doctor. and one of
INQUIRER STAFF WRITER
the first of many books that Children's
It was after 5-year-old Sharon Caldwell's
Hospital doctors will be giving tocity chil-
eye test, her ear test, the scale and the
dren.
blood-pressure cuff, and midway through
The three of them leafed through the
a page of questions designed to measure
pages together as James explained pic.
her Intellectual development that Dr.
tures, asked Sharon questions and gave
Stephanie James sprang the surprise.
McCoy pointers on how to read a book to a
She pulled a shiny new book, Wild Wild
child. Sharon's eyes brightened. She be-
Sunflower Child Anna, from Sharon's med-
gan answering James' questions more
Ical chart and began showing Sharon pic-
quickly and with more enthuslasm. The
tures of a little girl in a beautiful green
Ice was broken.
place full of flowers and animals. This was
"It's not really a gift," James said as she
a different world from the West Philadel-
prepared to continue the exam. "It's part
phia homeless shelter where Sharon and
of your health care because it's going to
her eight brothers and sisters live, but
get you all buffed up for school.
Sharon and Anna had the same energy,
Thursday, Children's Hospital launched
the same dark skin, the same wide smile
a new program from its three primary-
and big eyes.
care centers In the city. Called Reach Out
"I know you're a smart kid, and I know
and Read, the program will provide each
The Philadelphia Inquirer RON CORIES
your mom tries to read to you," the pedia-
child with a new book at every well-child
trician said as they sat Thursday In an
visit: 10 books by the time a youngster
Sharon Caldwell hugs a book as Dr. Stephanle James tells her that she'll be
examining room at Children's Hospital of
starts school. The centers will also have
allowed to take it home with her. That's Sharon's mother, Wanda McCoy,
Philadelphia's Primary Care Center at
used books for patients' brothers and sis-
behind the doctor. Sharon had just completed a checkup.
Cobbs Creek.
ters. Eventually, volunteers will read to
"Oh goodness," Sharon's mother, Wanda
children as they wait for the doctor, not
ales in 13 large urban hospitals and many
the prevention trend in pediatrics. They
McCoy, chimed in. "I be reading to them
only making the wait more fun but show.
smaller neighborhood health centers.
try to keep children from being hurt by
at night, and they be wanting stories on
ing parents how to help children get the
Proponents hope the program will pre-
teaching parents about safety. They give
top of stories."
most from a book.
vent school problems by introducing poor
shots to ward off dangerous childhood dis-
James wrote Sharon's name on the In-
Reach Out and Read started seven years
children and their parents to books early.
enses. Why not also by to prevent school
side page. This would be Sharon's book.
ago at Boston City Hospital and now oper-
Doctors see It as a natural outgrowth of
See BOOKS on B3
The
Philadelphia
inquirer
RON CORTES
Dr. Stephanie James reads to Sharon Caldwell. Sharon's mother. Wanda McCoy, had brought Sharon to
the Children's Hospital of Philadelphia Primary Care Center at Cobbs Creek.
Children's Hospital prescribes
a dose of reading for the children
BOOKS from B1
fore children learn to read. just as
sized to parents the importance of
failure with an early dose of books?
spoken language begins before a
reading. knowing full well that
Although there is some evidence
baby says its first word.
some of them may not have a book
from the Boston program that chil-
She talks to parents about the con-
in the house. Now she knows her
dren who have been exposed to
nection between books and love.
patients will have books.
Reach Out and Read are more likely
how children come to like books be-
"I think it's just perfect." she said.
than their peers to look at books. no
cause they associate them with cud-
"I love it."
one knows yet whether it improves
dling in their parents laps. This is
Toward the end of Sharon's exam
achievement.
not about teaching your children to
yesterday. as her mother and James
But the staffers at Children's
read, she tells parents. some of
tried to figure out what shots she
thought the program made so much
whom may be a bit intimidated by
would need. the girl began fidget-
sense that they decided not to wait
books themselves. It's about teach-
ing. hopping around the room while
for hard facts.
ing them to love books.
her long. thin braids swaved around
"It's so intuitive to most parents."
The books can also be helpful to
her face. James handed her Wild
said Trude Haecker. the hospital's
the doctor. who can observe the
Wild Sunflower Child Anna. Sharon
medical director of primary care.
physical skills of children as they
stopped for a while to look at the
"We didn't feel that we needed to
reach for books or turn pages. Doc.
bright pages. allowing James and
prove the point. really."
tors can evaluate language skills as
McCoy to finish their conversation.
After months of planning. staff
children describe what they see.
Sharon took the book to her mother.
members started the program with
Books also calm children down and
"Mama. where's the bumble bee?"
financial help from the Boston pro-
make it a lot easier to talk to their
she asked.
gram and the hospital's Women's
parents.
They found a bee. and James
Committee. They expect to give
Distributing books is also some-
pointed out some daisies and black-
books to 30.000 children a year at a
thing nice that doctors can do. Too
eyed Susans.
cost of $50,000.
often. children associate pediatric
"We're going to read this to-
On Wednesday, Perm Klass, a pedi-
visits with shots and blood tests.
night." McCoy said.
atrician who is involved with the
At the Cobbs Creek center yester-
Sharon hugged the book to her
Boston program and is nationally
day, staff members spent much of
chest.
known for her books on medical
the morning reading the children's
"We can keep it?" she asked.
training. helped teach 175 center
books and reminiscing about their
"That belongs to you. James told
staffers about Reach Out and Read.
childhood favorites. They giggled at
her. "That's part of keeping you
"I've become a little messianic on
a potty-training book and spoke in
healthy.
the subject." she said as she stood in
reverent terms of another book
a hospital auditorium. She says she
about an iconoclastic young girl
To Help Out
feels much the same way about chil-
with a penchant for offbeat hairdos.
dren who go without books as she
It is that kind of love of books they
To become a volunteer
does about those who have no food
hope to convey to their young pa-
reader or to conate COOKS. call
or heat. They. too. have been "de-
tients.
590-2001
Fred Savage in "No One
ould Tell." about teenage
TE WAY WE LIVI
ting violence. Page 5E.
onday, May 6, 1996
Detroit Free Pross
a book day
Detion
ROAR volunteer Joseph Heed reads a story to Michelle, in Mickey Mouse shirt. Lorises and Louis McCasicill at
Children's Hospital of Michigan.
BY CASSANDRA SPRATLING
Children's doctors
In an example ní the increasing role pediatricians
Item Staff Wreen
as playing in promoting the health and well-being
sking the children to the doctor is no
T
prescribe books
of children. doctors al Cluldren's Hospital of Michi-
fun for & parent. If one of those things
gin. Si. John Hospital and Medical Center and
you do because you have to. And with
other hospitals across the country are putting liter-
four children. ages 1.4. 6and 8. includ-
to fight the disease
a y high on the sheives of their medicine cabuners
ing one with asthma, Roseann
There's a direct correlation between illneracy
McCaskill has 10 do It a for
of illiteracy
and the kinds of children to will end upin our enx
But her last trip to the general pediatric clinic of
& ncy ruoms and hospitals. "Dr. Teresa Holtrop sawi
Children's Hospital of Michigan was surprisingly
in a recent seminar that explained the ROAR pru-
pleasant
"When YOU have to come here with more than one
g am to new doctors training to be pediatricians al
In the waiting area of the Detroit hospital. as baby
child in tend 10. it can be very hertic But look at them:
Children
livera snuggked and wiggled in M Caskill's lap. her
they ve been sitting here paying citention ever since
What WC re irving 10 do IS get vnii In look at illit-
three okler children sat quietly listening while hus
he sal down. Having someone reading 10 them and
e acy as a disease that allerts the club) , well- being
pital volunteer Brother Joseph Keed read stories to
keeping their minds occupied - it sa good idea
at le grows up. The children who can 1 read well are
them and other
children.
It called ROAK - Reach Out and Read - and
the ones who WT will see later with
wounds.
"I was so happy that be casme and asked if he
it's the hospital's latest prescription for preventive
read 10
says McCaskill. of Detroit
medicine
Please see ROAR. Page 4E
Doctors help
VOLUNTEER To READ
Children's Hospital of Michigan n eds vol-
fight illiteracy
unleers to read to children and financi I contri-
butions to buy new books. The hospital pro-
vides training and asks that volunteers agree
10 read for a minimum of a half-day a week,
from about 9 a.m. 10 noon or 1 to 4, for at least
ROAR, from Page 1E
three months. To volunteer, call the hospital's
early pregnancies and other behavior problems."
Volunteer Services Office and specify that you
Holtrop, a pediatrician on Children's mobile team,
want to volunteer for Reach Out and Read. Call
learned of the program from one of the men who
1-313-745-5326 from 8:30 to 4:30 we ekdays.
developed it, nationally recognized pediatrician and
To contribute money for books or to donate
children's advocate Dr. Barry Zuckerman of Boston
new books, call the hospital's Child and Family
City Hospital.
Life Department at 1-313-745-0064 from 8-
Zuckerman and another pediatrician, Dr. Robert
4:30 weekdays.
Needleman, now in Cleveland, started ROAR six
To make a contribution, volunteer to read
or to obtain more information on the program
years ago.
The program is based on the connection between
at St. John Hospital and Medical Center call its
reading and children's well-being - and is rooted in
Volunteer Services Department at 1-313-343-
Zuckerman's philosophy that many factors contrib-
3680 from 8 to 7 weekdays. Drop be
ute to a child's health. Illiteracy, the argument goes,
donated books are located throughout the
helps begin a downward spiral that very often leads to
hospital.
school failure, which correlates with substance abuse
at a young age, teen pregnancy. delinquency and
ard Scarry's ABCs." "Ten, Nine, Eight" and other
other problems.
children's favorites.
So, Zuckerman and Needleman set out to develop
Holtrop. who led the session, told them the books
a program that would foster childhood literacy.
could also be a tool in their evaluations of the child's
it began almost by happenstance. They noticed
social and physical development. "When you hand
that when teachers came into their clinics armed with
him a book, is he interested? Does he grab it? How is
crayons and books to do educational assessments. the
his grasp?"
children often wanted to keep the books. It occurred
The pediatric residents received a char outlining
to the doctors that children who learn to read well
reading-related skills children should have leveloped
early on tend to have better health outcomes later on.
by certain ages. Between 12 and 18 months. for
So. they reasoned. why not give them books they
example, a child should be learning to hold a book
could keep?
with help, turn pages - though it may be several at a
The doctors applied for grants to purchase new
time.
books. mostly for children from low-income families,
None of the doctors seemed taken aback by the
and began incorporating the promotion of literacy
addition of this new task to their things-tc-do list.
into their medical treatment.
"I agree early literacy is important. because it
The Annie E. Casey Foundation. which assists
sets the pace for your entire life." said pediatric
low-income and disadvantaged families, was so in-
resident Dr. Crystal Morrison.
pressed with ROAR it gave Boston City Hospital a
Dr. Maha Dabbagh said it seems like I natural
grant to encourage other hospitals that wanted to
part of what doctors should be doing. "Were sup-
duplicate the program.
posed to be involved in everything relating 10 the
Reading, talking, giving
kid's development. This is a new clung. but It S a good
thing."
Laurie Dayton, an administrator at Children's in
Detroit whose job it is to help make visits there more
Real results
pleasant, heard about ROAR at a health conference.
Other hospitals' literacy programs vary slightly.
She and Holtrop joined forces. and Children's became
The one at St. John Hospital and Medical Center
one of nine hospitals nationally to develop ROAR
in Detroit, for example, is called RX: Heading.
programs.
Donations help pay a part-time staff person :0 read 10
ROAR has three elements:
children in the medical center's waiting area. but the
Trained hospital volunteers, armed with a bag full
program also incorporates giving away nev' books
of children's books. read to children in the waiting
and counseling parents on the importance of eading.
room. This exposes children 10 good books. keeps
Separate assessments of these programs show
them entertained and shows parents some important
that children who've participated are more I kely to
elements of reading to children - interacting with
be regularly engaged in reading-related acuvities at
them, asking them questions and encouraging discus-
home.
sions about the stories.
St. John. for example. did a telephone survey of
Pediatricians talk with parents at each well-baby
parents whose children had participated in its pro-
visit about the importance of sharing books with
gram. It found that the number of times parents read
children every day. Pediatricians at Children's are
to their children each week went up about 20 percent
taught that promoting literacy should be as much a
after being counseled about reading by a tor.
part of their routine as talking with new parents
"The results of the study support the contention
about the importance of proper nutrition and immuni-
that a simple. inexpensive intervention by primary-
zations.
care physicians or their staff can lead to sitive
A free book is given to each child at the end of each
changes that may result in increased success in
well-baby visit - the regular office visits in which a
acquiring reading skills during infancy. prescho ol and
pediatrician assesses a child's general health and
the early elementary school years." said Dr. Thad
development and updates immunizations. Usually.
Jos, a pediatric allergist and co-founder of the
that amounts 10 10 visits from age 6 months 10 5
program at St. John, now entering its third year.
years.
Back in the waiting area at Children's Hospital.
"If a child gets a new book at the end of each visit,
where volunteer Joseph Reed was reading 1) Ro-
that's 10 new books for a child who might not
seann McCaskill's kids, his young audience had
otherwise have books in his home." said Dr. Perm
grown from three to seven.
Klass, who co-directs the ROAR program in Boston.
Reed. who does his volunteer work during sum-
"That means it costs about $30 to $40 to start a
mer vacations and breaks from his job as a teacher at
home library for a child - less than the cost of one
De La Salle High School in Warren. showen the
blood test. That seems to me 10 be a modest
children the selection of books and allowed the III to
investment for a potentially tremendous payoff."
pick one for him to read.
At the recent training session at Children's
"I like 10 hear him read to me." said McCaskill's
Hospital. new doctors not only learned why they
8-vear-old daughter, Michelle.
should care about literacy. they got a refresher
After a couple of hours. Reed was about to take a
course in children's literature - an area that has
break when 3-year-old Leann Pacquette of Melvin-
grown considerably since they were children.
dale made 4 plea he couldn't resist.
Twelve pediatric residents, accustomed to study-
"Read another one," she said.
ing high-level medical journals, sat around a table
And that's just what he did.
reviewing "Goodnight. Moon." "Cordminy," "Rich-
The Boston Globe contributed to this report.
CEN
BOSTON
R
MEDICAL
One Boston Medical Center Place
Boston. MA 02118-2393
REACH OUT AND READ NATIONAL SITES
Tel: 617 638 8000
85 sites in 34 states as of January 1997
Tel: 617 534 5000
ALABAMA
Lower Alabama Pediatrics-Brewton-Marsha Raulerson, MD new
ALASKA
Alaska Native Medical Center-Anchorage-Jerry Nasenbeny, MD new
ARIZONA
Kino Community Hospital-Tucson-Barbara Smith, MD new
Phoenix Children's Hopsital-Phoenix-Marcia Stanton, MSW, Jeffrey Weiss, MD new
Sage Memorial Hospital-Ganado-Rebecca Kazal, Louis Kazal, MD
CALIFORNIA
Child Crisis Center/UCLA Medical Center-Torrance-James Williams, MD new
North Orange County Youth & Family Resource Center-Anaheim-Sharon Latona, Deborah Stewart.
MD new
San Francisco General Hospital/UC San Francisco-Elena Fuentes-Afflick, MD, Annalisa
Abjelina, MD, Lois Epstein, MD new
Vacaville Community Clinic-Vacaville-Linda Hess, Stephen Boos, MD new
COLORADO
Family Health Center Pediatrics-Denver-Larry Wolk, MD, MSPH new
Sandos Westside Health Center-Denver-Steve Vogler, MD new
CONNECTICUT
Bridgeport Hospital Primary Care-Bridgeport-Allyson Driggers, MD new
Fair Haven Communtiy Health Center-New Haven-Laurel Shader, MD
Park City Primary Care Center-Bridgeport-Laura Buffone, Veronique James, MD new
FLORIDA
Pearl Plaza Pediatrics-Jacksonville-Karen Toker, MD new
Tampa General Hospital/University of S. Florida-Tampa-Sharon Dabrow, MD, Patricia Blanco, MD
new
GEORGIA
Hughes Spalding Children's Hospital-Atlanta-Linda Grant-Ready, Set Read! (new ROR)
Northwest Grady Clinic-Atlanta-B.J. Steele, MD new
Ware County Family Practice Center-Waycross-Brenda Landwehr, PA-C new
HAWAII
Kapulani Medical Center-Honolulu-Chris Derauf, MD new
ILLINOIS
Chicago Healthy Steps-Gail Wilson, Anita Berry, Delayne Rittmueller new
Evanston Hospital Perinatal Family Support Center-Liz Roehlk, M.Ed, Ronna Jacobson
University of Illinois-Chicago-Peter Neronha, MD, Marylou Schmit, MD new
INDIANA
Three Rivers Literacy Alliance-Fort Wayne-Ginny Clark, Sarah Reinke Read To Me
KANSAS
Kansas University Children's Center-Kansas City-Kathryn Veal, MD & Jean Harty, MD new
Mexican American Ministries Clinic-Garden City-Penny Schwab, Rebecca Clark-Hermocillo,
Esther Oppliger, RN, MSN, ARNP new
Overland Park Pediatrics-Charlaine Milliken, Kathy Sanchez, Kim Danaher new
KENTUCKY
Northern Kentucky Family Health-Newport-Joyce Huffer, ARNP & Carol Roark, MD new
University of Kentucky Family Care Center-Lexington-Thomas Young, MD new
LOUISIANA
Medical Center of Louisiana/University Hospital-New Orleans-Ellen Beyer, RN, Susan Berry, MD
MARYLAND
Druid Family Health Center-Baltimore-Delores Smith, Karen Nelson, MD new
Matilda Koval Health Center-Baltimore-Heather Neblett, MD new
St. Agnes Hospital-Baltimore-Barbara Burns, Michael Burke, MD
Shore Clinical Foundation-Easton-Cathleen McGrath, MD new
University of Maryland Pediatric Ambulatory Center-Baltimore-Alexa Cieslak, Virginia Keane, MDnew
MASSACHUSETTS
Brockton Hospital-Brockton-Jacqueline Hochstin, RN, CLS & Lisa Downs, MD new
Cambridge, Mt. Auburn, Somerville Hospitals-David Osler, MD new
Greater Lawrence Family Health Center-Lawrence-Elise Henricks, MD
Holyoke Health Center-Holyoke-Jane Cross, MD new
Holyoke Pediatric Associates-Holyoke-Anne Nugent, MD new
MGH Chelsea Health Center-Chelsea-Janice Lowe, MD new
MGH Revere Health Center-Revere-Harwood Egan, MD, Jennifer Liske, Susan Curley
Medical Center of Central MA/Memorial Hospital-Worcester-Keith Dubois
North Shore Children's Medical Center-Salem-Phyllis Groskin, Owen Mathieu
MICHIGAN
Children's Hospital of Michigan-Detroit-Teresa Holtrop, MD
Detroit Northwest Clinic-Erna Wilkerson, Teresa Ann Boles new
Kalamazoo Center for Medical Studies/MSU-Kalamazoo-Donald Greydanus, MD, Allan LaReau, MD
new
MINNESOTA
Children's Health Care Children's Clinic-Minneapolis-Nancy Almquist, CLS &
Stephanie Bisson, CPNP new
MISSISSIPPI
Jackson-Hinds Comprehensive Health Center-Jackson-Dana Carbo, MD & Eva Henderson, MD
MISSOURI
Humana Health Care Healthy Steps-Kansas City-Carol Dietzschold, Cherrie Fleming, RNC, Suzanne
Leeman, RNPNP new
Open Door Clinic-St. Louis-Dotti Kastigar, Helen Haney, MD new
NEW HAMPSHIRE
Lamprey Health Care-Newmarket-Sarah Oxnard, MD & Priscilla Shaw new
Nashua Child Health Clinic-Nashua-Christine Caron, Richard Slosberg, MD new
NEW JERSEY
Newark Beth Israel Medical Center-Newark-Judy Shoobe, MD, Charlene Kidd, RN, MS new
Osborn Family Health Center/Our Lady of Lourdes Medical Center-Camden-Georgiana Reynick,
Judith Shoobe, DO new
NEW MEXICO
Children's Hospital of New Mexico-Albuquerque-Julia Grimes, MLS, Barbara Small, MD
Farmington Community Health Center-Farmington-John Garretson, MD new
Las Vegas Clinic for Children and Youth-Las Vegas-George P. Bunch, MD new
Rehoboth McKinley Christian Hospital-Gallup-Herb Mosher, Mary Poel, MD new
NEW YORK
Child Health Clinics-NYC-Carmen Ramos-Bonoan, MD new
Court Street Diagnostic and Treatment Center-Utica-Charles McMahon, Thomas Clark, MD new
Foster Care Pediatrics-Rochester-Elizabeth McMahon, MD new
Metropolitan Hospital-NYC-Ruth Frank, Vidya Bhushan Gupta, MD new
Montefiore Marble Hill Family Practice-Bronx-David Savarese, MD new
NYU Bellvue Hospital-NYC-Linda van Schaick, MS, Jane Burton
Rochester General Hospital-Rochester-Randy Evans, Robert Byrd, MD, Michael Weissman, MD
NORTH CAROLINA
Mulberry Pediatrics/Caldwell Memorial Hospital-Lenoir-Vicki Coffey & Duane Herold new
Olson Huff Center for Child Development-Asheville-Adrian Sandler, MD new
Wake Medical Center Special Infant Care Clinic-Raleigh-Cindy Callahan, MA,
Melissa Johnson, PhD new
OHIO
Children's Health Clinic-Dayton-Terrie Kess, RN new
Crossroads Health Center-Cincinnati-Katie Connelly
Rainbow Babies and Children's Hospital-Cleveland-Robert Needlman, MD
OKLAHOMA
Children's Medical Center-Tulsa-Laura Taylor, DO new
PENNSYLVANIA
Children's Hospital of Philadelphia(CHOP)-Trude Haecker, MD
C. Eve Kimball, MD-Reading new
Lehigh Valley Hospital-Allentown-Suzanne Irvine, Terry Thomas, Cathy Rutman, RN new
SOUTH CAROLINA
Greenwood Community Children's Center-Greenwood-William Allen, MD new
SOUTH DAKOTA
Rosebud Sioux Tribe Healthy Start-Rosebud-Lucy Reifel, MD new
TENNESSEE
Memphis Family Care Center-Memphis-Gerri Cannon-Smith, MD new
TEXAS
Fort Bend Family Health Center-Richmond-Susie Benes, Susan Collins, Laura Wolf
Univeristy of Texas Medical School WIC Children's Clinic-Houston-Paige Atkinson, PNP new
VIRGINIA
Healthy Families/CHIP-Arlington-Anne VorderBruegge new
University of Virginia Children's Medical Center-Charlottesville-Linda Drake, Deborah Smith, MD new
WASHINGTON, DC
Children's National Medical Center GPAC-Sandra Cuzzi, MD new
Children's National Medical Center Child Protection-Lavdena Orr, MD new
2/25/97
REACH OUT AND READ (ROR)
THE PROBLEM
Children who live in print-rich environments and are read to in their preschool years
are much more likely to learn to read on schedule
Parents of children living in poverty may lack the money to buy books, may not have
easy access to good children's books, and may not themselves have been read to as children
Reading problems may mean school failure, which increases the risk of absenteeism,
dropping out, juvenile delinquency, substance abuse, and teenage pregnancy--all of which
perpetuate the cycles of poverty and dependency
PROGRAM DESCRIPTION
Reach Out and Read is a program that makes early literacy part of pediatric primary care
Pediatricians encourage parents to read aloud to their young children and give their
patients books to take home at all pediatric check-ups from six months to five years of age
Through Reach Out and Read, every child starts school with a home library of at least ten
beautiful children's books, and parents understand that reading aloud is the most important
thing they can do to help their children learn to love books
HOW ROR WORKS--PROGRAM COMPONENTS
Volunteer readers in the clinic waiting room read aloud to children as they wait for their
appointments, showing parents and children the pleasures and techniques of looking at
books with children
Pediatricians are trained to counsel parents about the importance of reading with young
children, offering age-appropriate tips and encouragement
The doctor gives the child a new developmentally and culturally appropriate children's
book to take home and keep at every check-up from six months to five years of age
PROGRAM BACKGROUND
Reach Out and Read was developed at Boston City Hospital in 1989 by a collaboration of
pediatricians and early childhood educators
In collaboration with the Association of American Publishers, ROR has developed a
Program Manual, handouts for doctors and parents, prescription pads to help doctors
"prescribe" reading aloud, and many other unique materials to encourage literacy in pediatric
practice
With generous support from the Annie E. Casey Foundation, the program has been
replicated in sites around the country; with further support from the William T. Grant
Foundation, Robert Wood Johnson Foundation, Boston Company, there are now over 80
Reach Out and Read sites in clinics and pediatric practices in 34 states
FOR MORE INFORMATION:
Please contact the Reach Out and Read office by phone (617)534-5701 or fax (617)534-7557
or write to Reach Out and Read National Training Center, Boston Medical Center, One
BMC Place, Dowling 5 South, Boston, MA 02118.
says he needs $6.5 million. Dem-
LETTERS
ocrats say $1.8 million is plenty
and threaten to filibuster any
GOP attempt to grab more mon-
The prescription for smart kids
ey. On Tuesday, the Senate is ex-
pected to vote on a constitution-
O
nce upon a time, bedtime stories were re-
childhood development to best use. "There's
al amendment to require
served for children who were old enough
a mismatch between when the brain is most
Congress to balance the federal
to understand words. But that will change if
easily influenced and when they're spending
budget. The amendment ap-
some grown-ups get their way. In his State
money to do the influencing," says Bruce
pears likely to fail by one vote,
of the Union message, President Clinton
Perry, associate professor of psychiatry at
just as it did two years ago.
challenged parents to "read with your chil-
Baylor College of Medicine. In other words,
dren every night," noting that "learning be-
the federal Head Start program starts too
Education. Education Secretary
gins in the first days of life." Next month,
late. One new initiative, Early Head Start, is
Richard Riley testifies on
the White House will convene a conference
aimed at pregnant women, infants, and tod-
Wednesday before the House
on early childhood learning and brain devel-
dlers. In another program called Reach Out
Committee on Education and the
opment. Film director Rob Reiner will
and Read, pediatricians in 83 hospitals
Workforce about the president's
organize a media blitz that will in-
and clinics around the country
education initiatives. Among the
clude a TV special, a CD-ROM, and
write out prescriptions for
proposals are national exams to
a video on the pint-size in-
parents to spend time
raise standards and tax incen-
crowd. The message: Expe-
reading with their very
tives to increase college enroll-
rience stimulates a child's
ment. On Thursday, Lamar Alex-
brain to grow, and early ex-
GOODNIGHT
young children every day.
Perri Klass, medical direc-
ander, former education
perience counts the most.
MOON
tor of Reach Out and Read,
secretary and GOP presidential
The brain reaches 80 per-
says, "We give shots to pre-
aspirant, appears before the
cent of its full development
vent deadly diseases, and
same committee. On Tuesday,
by a child's first birthday.
we talk about reading in
Federal Reserve Chairman Alan
Now that the baby's brain
that context." That practi-
Greenspan offers his economic
is no longer a mystery, the
cally makes Goodnight
forecast to the House Budget
question is how to put the
Moon required reading.
Committee. -David Fischer
latest understanding about
-Linda Kulman
10
U.S.NEWS & WORLD REPORT. MARCH 10. 1997
ILLUSTRATION BY MICHAEL MCPARLANE FOR USN≀ PHOTOGRAPHS (FROM TOP): COURTESY OF HOUSTON GRAND OPERA CHARLIE ARCHAMBAULT FOR USN&WR
Writing new rules on reading
Educators use federal mandate to try innovative approaches
http://www.usatoday.com
USA
TODAY
Life
A clinic on
reading: llan
Schwartz, left. of
the Boston Medi-
cal Center. gives
encouragement as
Martiza Yamilles
WEDNESDAY,
reads to her 1-
JANUARY
29,
1997
year-old daughter.
Urena.
COVER STORY
The push is on to ensure
teracy by third grade
one
their
Read
By Tt
a Henry
and community activists are trying to find
and Bein Ashley
"something that works." conventional or other-
USA TODAY
wise, to teach children to read.
The ability to read is a fundamental skill. Yet
Two years ago, Vicky Velasquez was a fourth-
neurly balf of the 44 million kindergarten-12th
arten
grader who couldn't read.
grade public school children can't read well.
Frustrated with constant schoolwork failures.
The nation's Reading Report Card showed
Vicky had become a withdriwn 10-year-old.
that in 1994. 41% of fourth-graders were reading
The was before Diane Crawford. principal at
below grade level. as were 31% of eighth-grad.
Elementary School in Uvalde, Texas, test-
PTN and 25% of high school seniors.
ed vicky and found she was an "extremely ki-
Experts any it's a crisis that can't be ignored.
netic learner" - that is. she learned best
Richard Long of the International Reading Asso-
through motion
clation considers below-grade-leve) reading as
The solution: The youngster was taught pep-
being functionally illiterate in today's high-tech,
squad cheers that gave each letter of the alphn-
glohni economy. He snys such rending skills
bet a body movement
were indequite in the 1070s but are not in the
"Somehow or another it clicked in her mind."
21st century If the nation is to maintain its eco-
Crawford says. "So when taking spelling tests.
nomic rdge or high standard of living
she pictures herself outside, making the moves
Alarmed by the statistics, President Clinton
Vicky is now a "solid" sixth-grader. The strain-
last August announced America Reads, n $2.75
gy. though unconventional. WIRS successful. And
billion. five-year Initiative designed to ensure
that's what matters to Crawford When it comes
that all children are literate by the third grade.
to reading she says. "we really work with the
Clinton proposed in offer federal funds to state,
child until we find something that works."
Across the nation, more and more educators
Please see COVER STORY next page
COVER STORY
Houston will launch its own reading program Friday
Continued from ID
states that will decide to do il as
focus on literacy."
Schwartz. a native of Mexico
Marie Carbo, executive di-
Crawford. Robb's principal.
the material. By last May. says
0 statewide emphasis."
An 8-year-old program at
who is a resident nl the center.
rector of the institute. says
also tells of Richard Trevino.
assistant superintendent Bar-
local and national programs
Other groups across the na-
the Boston Medical Center.
says Laune patients "are very.
third-graders are the targeted
who had difficulty reading in
bara Skipper, nearly 700 of
that would teach parents to
tion have major efforts to at-
now being replicated at clinics
very grateful" for the program.
group for school literacy pro-
the fourth grade, too. but now
the students were passing the
help children read.
tack illiteracy. Among them:
nationwide. has pediatricians
He explains that many are re-
grams because this is the age
is 0 reader. Tests showed he
test with a score above 70.
The initiative also would fi-
New York City's YMCA on
"prescribing" parental reading
cent immigrunts who have not
when 0 shift begins in schools
had "scoptic sensitivity." in
Skipper says the success of
nance individual tutoring for
Tuesday kicked off an extend.
sessions for children and send-
yet had the time to and day
She says teachers start to place
which black letters on white
the Reading Styles Institute
children in kindergarten-third
ed school day program with 111.
ing a book home each time a
care centers or early child-
more demands on students
paper produced R glare. Craw-
program has now made
grade. Volunteer tutors are be
erucy as the theme. YMCA of
child visits. The Reach Out and
hood programs for their young-
with homework. book reports
ford says that help for Richard
Uvalde teachers believe that
ing recruited from all areas. in-
Greater New York president
Read program hegan when pe-
sters Also. he says. many have
and other activities that re-
was "as simple as running his
all children can learn to read
cluding college students in.
Pnulo Gavin savs the $5.5 mil-
diatricians noticed that poor
lived in countries that do not of-
quire reading comprehension
work off on color paper. It
by the third grade.
volved in the federal work.
lion "Virtual )" program will
kids wanted to take books from
fer library services.
and analysis. A child who can-
wasn't glaring any more. he
But to accomplish that goal.
study program to finance their
be opened in 200 schools over a
clinic waiting rooms because
The Reading Styles Insti-
not read at the expected level
could really read It."
she says. "you have to be very
education.
two-year period. targeting
they had none In their homes.
tute in Syosset. N.Y., proposes a
in the third grade suddenly is
Farm families make up
focused on reading and very
The goal. says Carol Rasco.
10,000 students in grades two-
"On every single patient. we
number of rending strutegies
at 0 great disadvantage in all
most of Uvalde: 2007 are mi-
committed. That means
whom Clinton appointed to
four. The program is consid-
spend 10 minutes of the visit
the 10 model schools it oper-
other subjects and will quickly
grant farmers.
that we sometimes teach read-
oversee America Reads. is for
ered the largest privately fund-
explaining how important it is
ales and the five new schools
fall behind his or her peers
Seventy-eight percent of the
ing more than once during the
children to read "well and in-
ed initiative in the Y's history
to read." says Ilan Schwartz
targeted to implement its pro-
Robb Elementary School.
students are Hispanic. many
day. We sometimes keep the
dependently" at grade level.
and is an offshoot to both Clin-
Kids at the clinic not only get
gram. Institute trainers work
where Vicky Velasquez attend-
have limited proficiency in
kids after school and work on
On Friday, Houston will be
ton's program and an initiative
gift books with each visit. but
with 200 school districts 0 year
ed the fourth grude, formed a
English. and 759 come from
reading We work with them in
the first city to launch Its own
of school chancellor Rudolph
they also hear stories rend by
and estimate it has trained
partnership with the institute
families considered economi-
the summer on reading."
America Reads program. Edu-
Crew.
volunteers in the waiting room.
100,000 teachers in its 12-year
in 1993. and many of the Insti-
cally disadvantaged.
It's a goal worth the effort,
cation Secretary Richard Riley
"The estimates here In New
Schwartz says the children's
history. Teachers are taught to
tute's strategies have been
When the school district first
she says.
will toin Mayor Bob Lanier in
York City are that only 40% of
progress is evaluated every six
identify B child's strength and
adopted as part of the curricu-
used the strategies in 1993. only
"If they can't read, they
for a celebration that
young people at the third grade
months during periodic check-
teach reading using those
lum throughout the entire
219 of the students at some
can't do science or social stud-
includes visits to elementary
are reading at grade level. Ga.
ups. Children ages 4 and 5 "tell
strengths. whether it's using
Uvaide school district. Vicky
grade levels had correctly on-
ics or math. If we want kids to
schools and literacy programs.
vin says. "We're trying to take
us how good the book was, and
phonics. whole language. a
was among the first group of
swered 700 or more of ques-
be productive in the future,
Other cities will follow.
the best of what the Y has al-
you can see how the moms
combination of the two. record-
students to benefit from the In-
tions on a reading test - the
they are going to have to be
Rasco predicts. as will "some
ways
done
and add a real
spent some time with them."
ed books or choral reading
stitute's program.
level that indicates mastery of
able to read."
VIEWPOINT
Hillary Rodham Clinton
Comfort and Joy
The First Mom suggests reading as an easy way to help a baby's brain grow
HE NIGHT AFTER THE INAUGURAL, BILL AND I GATHERED
ation and the American Library Association, a national
T
with our family in the solarium on the third floor of the
campaign to put books in the hands of parents who bring
White House. After dinner our toddler nephews Tyler
their young children to the doctor, and to get doctors to
and Zachary climbed up on the couch with their Uncle
prescribe daily reading. My husband and I will be dis-
Bill to hear him read a story. They accompanied him with
cussing this and other activities to follow up on the latest
words, sounds, pointed fingers and a few tussles over who
findings about the brain at a White House conference in
would hold the book. As I watched them, I thought of all the
the spring.
times Bill and I used to take turns reading stories to Chelsea.
It's important that we take to heart what the neuro-
Every night one of us (and occasionally both) would stretch
scientists are telling us-without losing the heart of the
out on her bed, hold her in our arms, and either read or
reading experience. In today's high-tech world of E-mail
make up new tales about imaginary characters who em-
and microchips, it is easy to forget the importance of hu-
barked on improbable but breathtaking adventures.
man connections in our daily activities. Technology has
Bill and I did not know about brain cells or synapses or
brought many welcome conveniences to our lives. But it
the newest discoveries in neuroscience. Reading to
has the potential to create feelings of distance, detachment
Chelsea became a daily ritual because it's what our own
and isolation among us.
parents and grandparents had done with us, and because
Reading to a child while touching, hugging and hold-
we wanted to spend quiet time with her every day. Bill's
ing him or her can be a wonderful antidote to the im-
grandmother thought that
personal tendencies of the
reading to him would help
information age-for both
him develop a strong vo-
the adult and the child.
cabulary and the language
While critical to building
skills he would need later
brains, reading is equally
on in school. My mother
important to building
and father placed a similar
trusting and close relation-
premium on reading, and
ships. That's why many of
to this day I remember the
us remember the warm
feelings of security and
embrace or the comfort-
comfort that I felt sitting in
able lap that cradled us
my grandfather's lap when
when we read books as
he read stories to my
children. And that's why
brothers and me.
reading should not be
Today, thanks to ad-
viewed solely as an intel-
vances in brain research,
lectual proposition, par-
we know that reading with
ticularly in the era in
a child has intellectual,
which we now live.
emotional and physical
If Americans take away
benefits that can enhance
Mrs. Clinton with her daughter in the crucial first three years
only one lesson from these
the child's development. The intimacy of sharing books
exciting scientific discoveries, I hope it's that reading to
and stories strengthens the emotional bonds between a
children is easy, affordable and feasible for parents no
parent and child, helps a child learn words and concepts,
matter what their level of education or economic station in
and actually stimulates the growth of a baby's brain.
life. Children's books are available for free at public
As I discussed in my book, It Takes a Village, scientists
libraries in every community and can be found at reason-
have discovered that children whose parents read and talk
able prices in many bookstores. Doctors, librarians, teach-
to them during the first three years of life create a stronger
ers, book publishers, business leaders and the news media
foundation for future reading success. In other words,
can help make books available to families and educate
what our parents and grandparents knew instinctively is
parents about the vital role that reading plays in our chil-
now backed up by hard scientific evidence.
dren's lives.
That's why doctors and nurses are starting to pre-
It isn't very often that we have before us such a simple,
scribe reading to babies along with regular checkups and
inexpensive and pleasurable way to improve our children's
vaccinations. Recently I went to Georgetown University's
health and development and raise their prospects for a
Medical Center with Maurice Sendak, the renowned
brighter future. Whether you lie down together on the rug,
children's author and illustrator. His book Where the
sit together in an old rocking chair or cuddle on your
Wild Things Are was one of Chelsea's-and Bill's-fa-
child's bed the way Bill and I used to with Chelsea, there
vorites. Mr. Sendak read the story to children, and I an-
is no better way to spend time than reading to your child.
nounced, along with representatives of the American
And now we also know that there are few better ways
Academy of Pediatrics, the American Booksellers Associ-
to help your baby's brain grow.
TIME, FEBRUARY 3, 1997
63
THE KANSAS CITY S AR.
February 20, 1997
JOHNSON COUNTY EDITION
50c
as.com
Hillary Clinton visits KC
China's
senior
leader
AY'S STAR
is dead
top virus
d illness that
is hitting
Deng Xiaoping, 92,
area hard
pushed economic reforms,
resisted greater freedoms.
From Star News Services
blues
BELING - Deng Xiaoping, the last
of China's Communist revolutionaries,
who abandoned Mao Tse-tung's radical
C.W.
policies and pushed the world's most
Gusewelle
populous nation into
says we've
the global community
finally
with capitalist-style
reforms,
died
reached the
Wednesday.
point in
Xinhua. China's of-
winter
ficial news agency,
said he was 93. al-
where hope
though the birth date
and imagi-
in most records
us
TAMMY LJUNGBLAD/The Star
would have made him
92 when he died.
Americans must "work together to make sure every child gets
day at a Stand for Children rally at the University of Missoun-
Though Deng re-
Deng
what any child needs," Hillary Rodham Clinton said Wednes-
Kansas City.
tired from his last of-
ficial post in 1990 and had not been seen
in adult
in public for three years. he spent much
Children have ally in first lady
of the last decade orchestrating Chinese
ent
politics from behind the scenes with 1
changes
loosely defined title: "paramount
leader.
adult en-
Dene's death probably won't have an
suing a
By DONALD BRADLEY
Cosby at 1 Bovs & Girls Clubs
immediate effect on U.S.-China rela-
and DONNA McGUIRE
of Greater Kansas City bene-
Segal. C-1
"We know what children need and what
tions experts said.
fit.
Stall Writers
"In practical terms. in the short run.
works. There's not a problem in America that
At one point. she received 1
there are no consequences. because the
First lady Hillary Rodhum
bumper sticker that read: is it
has not been solved somewhere in America."
alling Deng had not played 1 major roie
Clinton championed two of
good for the children? That's
in Chinese decision-making for the last
her favorite topics children
the number one question."
Hillary Clinton
See DENG, 1-16, Col.
and helping women become
What we have to do now :s
County
self-sulficient while dashing
work together to make cure
will
decide
through four Kansas City
every child gets what any child
events Wednesday.
read a few minutes each day to
fice
needs. Clinton told about 500
to
allow
She came to help start a Chil-
their children.
Clinton also posed for pic-
people at 1 Stand for Children
waed
dren's Mercy Hospital pro-
The program also asks all
tures with children. challenged
rally It the University of Mis-
Singer's
gram. modeled after one in
area pediatricians to "pre-
adults to support children and
souri-Kansas City.
tower
1
Bostons low-income neighbor-
scribe books to children every
capped the day alougside an-
On Wednesday evening.
hoods. that calls on parents to
time they visit the doctor's of-
other child advocate. Bill
See HILLARY, A-14, Col. 1
garb stirs.
Is she role model or woman scorned?
firestorm
By STEVE KRASKE
Olathe Republican. She doesn't hold back.
Even though Clinton took on 1 lower
Postical Correspondent
either.
profile at the start of her husband's second
Plaza
"I really view her as pretry much a non-
term. she stands as 1 pivotal figure. if only
Pat Boone's TV show is
Ask Mollie Carroll about first lady
credible person." O'Connor said. -1 think
because of the political havoc she could
City
Hillary Rodham Clinton and the words
many of her notions are very socialistic."
wreak if indicted in the Whitewater scan-
off air amid complaints
be
close
gush out.
So what is Hillary Clinton? Role model
dal.
over heavy-metal attire.
the
master
-1'd stop a builet for her." Carroll said
or bad example? Courageous national
She remains a lightning rod who rarely
Country
Wednesday. minutes before Clinton spoke
leader or presidential partner who doesn't
attracts anything but heartielt passion.
Los Angeles Times
at the Hyatt Regency Crown Center hotel
know her place?
C-2
"I think she is what women in the 90s are
Five years after becoming first lady. Clin-
Her fans are devoted. Her enemies are
Pat Boone has been taken off the iif
all about."
ton remains a national debate in progress
more than a Little annoyed by her. When it
by a national religious television net-
Now ask Kansas Rep. Kay O'Connor. in
And there's no end in sight.
See CAN'T, 1-14, Col. 5
work after showing up at the American
Music Awards dressed like a heavy-
metal rock singer.
Trinity Broadcasting Network
dropped Boone's weekly half-bour show
on Tuesday after receiving thousands or
Fans of fish
telephone calls and letters from contrib-
utors who were shocked by Boone's
bare-chested leather costume at the
High:
get their wish
awards show. It was broadcast Jan. 27 by
0
12
2
4
8
8
ABC.
THURSDAY
"A lot of our (prayer) "partners had 1
A crowd gathered Wednes-
real problem with that
than 2.
COOLER
at Shawnee
n
lot." said an employee of Trunty, whose
Park not to pull trout out
programming is carried by nearly 400.
Hillary
Can't live with her,
Clinton
can't live without her
KC
Continued from A-1
Children
comes to neutral opinions, not
Hillary speaks
many exist.
"I wanted to run up there and
*TOUCH
1115
take a picture but I know her se-
from
A-1
curity people wouldn't let me,"
To hear excerpts from
Kansas
Leona Johnson said shortly after
City.
Hillary Rodham Clinton's
Clinton's speech at the Women's
Wednesday evening, about
speech Wednesday at the:-
Employment Network fund-rais-
hildren applauded Clinton
Women's Employment
ing luncheon. "I hate to sound like
she entered a room at Bartle
Network in Kansas City
a kid in a candy store but I'm real-
for the Boys & Girls Club
call (816) 889-7827 and
ly proud of her. She has 10 elo-
enter 1115.
applauded them back.
quence about her."
As President Clinton's second
so happy to see all of you
she said. "I've been in
term unfolds Hillary Clinton is in
City all day and when I
an unusual position for a first lady.
TheStar.
you were going to be here for
Polls show that her approval rating
is lower than her husband's
tonight, I wanted to come
Hear RealAudio of the
see some of the best boys
A December survey taken by
first lady's speech in its en:
in the United States"
CBS News put Hillary Clinton at
tirety and get more informa
then addressed about 2,000
55 percent approval. compared
tion about ner positions
gathered in 3 separate room
with 36 percent disapproval. Her
women's and children's is
und-raising dinner.
husband stood at 60 percent ap-
sues when you visit The
IS nothing more impor-
proval and 31 percent disapproval.
Star's site at
providing opportunity
The good news for the first lady
http://www.kansascity.com
children to feel safe and
was that her numbers were way up
she said I thank
from January 1996. when she
stood at 42 percent approval and
kansascity.com
and Girls Clubs for lead-
way, for snowing that if we
47 percent disapproval.
children's needs first, the
More troubling for Hillary Clin-
ton. 41 percent in December still
Columbia who has studied
community can prosper."
expects to spend the next
thought she had too much influ-
lady. "One of the things tha
working on behalf of
ence on her husband, compared
women are supposed to do "
and families in areas such
with 44 percent who thought it was
be one thing or another a ser
health care and foster
"about right."
kitten or 1 villain. But they can
In large measure, Hillary Clin-
be a compiex person.
events she attended
WENDY YANG/The Star
ton's increased approval rating,
But Clinton is exactly that
esday
to
like her husband's was due to an
Brown said. She is a mother
on children.
In one of four Kansas City stops Wednesday, first
people at a Stand for Children rally at the Universi-
fourth was 3 fund-raising
image makeover. Gone was the
lawyer. first lady. children's advo
lady Hillary Rodham Clinton spoke to about 500
for the Women's Employ-
ty of Missouri-Kansas City.
hard-driving champion of national
cate, health-care crusader
Network. where the audience
health-care reform. In came a
some peopie. that's too much
noved by 3 former welfare
astounding effects that early stimu-
In the audience were community
and together to stand for chil-
more traditional first lady who
Clinton is now experiencing
story about resurrecting 1
lation through physical touch and
leaders, children's advocates and
dren."
pushed causes such as children and
what Brown called 1 conservative
by a drug-addicted hus-
talking have on infants and young
people who rode a bus to Washing-
Organizers handed out a blue
family issues
backlash Americans appeared**
Tears st ied down the
children." Kilo said.
ton last June to attend a Stand for
sheet that listed 100 ways people
"She's become more of a sup-
embrace the first lady early in in
face as she returned to
At Children's Mercy, volunteers
Children rally.
could stand for children, such as
porter of her husband's agenda
first term when people
where Clinton shook her
will be on hand to read to children
Federal and state officials rattled
visiting a library. checking home-
and priorities, and that is in con-
to new ways. But that changes
and thanked her for telling
in waiting rooms and doctors will
off long lists of programs already
work and sharing hobbies.
trast to the impression Americans
after she became enguifed
counsel parents on how to use
established or soon to be imple-
Then they asked each guest to
had in the first term," said Larry
Whitewater
books to help their child's develop-
mented that will help children. in-
list ways they could help by filling
Sabato, a University of Virginia
"This country is still very am
Out and Read
ment. Every child will leave with
cluding an improved training pro-
out 1 personal commitment form
political scientist. "You can't lose if
bivalent about women in power
Children's Mercy, 6-year-old
an age-appropriate book.
gram for foster parents
on the back of the blue sheet.
you're talking about children's
and women themselves
Grayson didn't jump on
Kilo predicted that more than
Then Jim Caccamo, executive di-
Not everyone was thrilled with
health care and education."
ambivalent about their
bandwagon.
30,000 children will benefit from
rector of Partnership for Children.
Clinton's VISIL
The role she will assume over the
editor Anne Mollegen Smith
oupie of minutes before the
Children's Mercy's efforts. She
proclaimed that Kansas City IS be-
A handful of abortion protesters
next four years remains to be seen.
Media Studies Center forum las
entered a hospital room
asked for Kansas City's help in
coming the child opportunity capt-
waved signs at her motorcade as 11
in September. the president said he
fall.
to 3 group of children. 1
providing donations and "an end-
tal of the world. He predicted that
neared her stop at UMKC.
wanted his wife to focus on re-
At the same meeting. Reguali
handed each child a copy
less supply of books."
in five years when Partnership for
"She says she's such a big sup-
forming the welfare system.
can pollster Kellyanne Fitzpatric
You Give a Moose a Muffin.
Jenny and Jeff Hunter of Blue
Children's 10-year campaign ends,
porter of children. but she's not
"That's the first I've heard of it."
said Clinton was born It the wron:
Jakob said with a scowl.
Springs applauded "Reach Out
the city will receive an A for the
standing up for the unborn." said
Hillary Clinton then said on
time. If she had come along
it aside.
and Read.
way it treats children. Large gains
Hilary Trossen. a demonstrator.
ABC's "20/20."
years earlier. she would notinaw
body said that "Reach Out
Their daughter. Lily. 5. was one
are needed. however. because the
Shortly after noon. about 1.200
In December. the president said
tried to be such in assertive lits
lead" would be an casy sell.
of the children Clinton read to
city received J C-plus on its last re-
people - most of them women
her mission would be "human
lady. If she had been born 10.year
vouid like to see the
Wednesday, and she could 00 the
gave Cinton .1 stateing it
lights
rater. the would nave run
Mercy reading program
programs poster child.
Before Mayor Emanuel Cleaver
the Women's Employment Net-
Later that month. the first lady
herseit.
nationwide She visited just
"She's read 5CO books SO far this
introduced the featured speaker. he
work unnual fund-raising iun-
said her tocus would be children
"The cruei trick of timing
her husband told Amen-
school year." Jenny Hunter said.
motioned 15 children - 12 of
cheon at the Hvatt Regency Crown
and family - "issues that I have
put her where she is.
40 percent of its fourth-
Lily. 1 kindergartner. began
whom attend day care at St. Vin-
Center hotel.
worked on for more than 25
said.
don't know how to read.
looking at books during regular
cent's Operation Breakthrough
The ballroom's walls were deco-
years. Those issues made up
So the debate rages
racy is expected to be 1 focus
trips to Children's Mercy for cere-
toward the stage
rated with 2.000 red hearts. each
much of her emphasis Wednesday
esident Clinton's second term.
bral palsy.
representing someone who had
in Kansas City, where she also
1 don't think she 1
One by one. the children lifted a
lary Clinton put out 1 call for
giant. heart-shaped poster. look 1
read to patients It Children's
role model." said Tim Goice,
"And we read to her all the time"
graduated from the network's pro-
Treds of Kansas City volun-
her mother said. "One day she
deep breath and beited out the
gram.
Mercy Hospital.
abortion appoinent n Johnson
to fill in for parents who
started to complete the sentences
message he or she carried.
Clinton challenged the audience
Subato suggested another mis-
County She and 31.
both sound very conservitive
crack a book.
Every child has that potential.
"Join my PTA!"
to take advantage of welfare re-
sion: "Stay out of controversy."
But the first lady was controver-
but their actions prove otherwise
ading to her daughter.
They just need 1 little push.
"Ask me what I think!"
form. America must provide jobs.
sea. was a daily ritual, Clinton
Parents have :0 issume the role.
sial from the start. Her bold stvie
To me ICS double-tark. it's type
"Get to know kids in the neigh-
day care and transportation to
critical."
She told 1 Children's Mercy
Clinton said.
borhood!"
help welfare mothers succeed. or
made some wince She spoke out.
ence that reading to children
-live not met many parents who
In her 2-minute speech. Clinton
the reforms will fail. she said.
She called for dramatic changes.
Then there's this: "She whibit
ngthens bonds. enriches vo-
didn't want to do best for their
"I don't delude myself about the
She took pride in carrying out 1 set
for us. the :dea that women CII
explained the Children's Mercy
lary and helps a baby's brain
children. but I've known 1 lot
reading program and mentioned
difficulty that we face" she said.
of duties completely separate from
pretty much do whatever the
ow."
myself included - who didn't
several of the president's gouls in-
"Many factors conspire to keep
her husband.
want to do." and Imogene Reed.
chele Kilo. chief of develop-
know what that meant. Clinton
volving children. such as health
women on welfare and out of
America had not seen anything
Health Midwest nurse who lis
tal medicine and behavioral
said.
care for those who lack it.
work. And many of the ingredients
like It since Eleanor Roosevelt.
tened to Clinton's speech.
ce at Children's Mercy. said
"1 think we are at a turning point
10 assist women off public assis-
Whitewater and Clinton's high
The tirst lady $ caught in
Stand for Children
ological research backs up
in this country." she said. We
tance are ones that have to be
protile in health-care reform
quandary. suggested Masour
on.
Later in the day. Clinton was one
know what children need and what
looked at carefully and packaged
brought endless problems and gave
Rep. Bonnie Sue Cooper 1 Kuna
e brain at birth has all the
of 51% speakers who addressed
works There's not a problem in
on 1 much bigger scale than even
opponents new reasons to scorn
City Repuolican. All worder war.
cells it will ever have but the
"Giving Our Hearts to the Chil-
America that has not been solved
(the Women's Employment Net-
her.
someone they can accure
lections can change dramati-
dren." an invitation-only rally at
somewhere in America Our
work) has been able to do."
"People have 1 hard time catego-
"But we aiso would like :tem I
if property stumulated such
UMKC organized by Kansas
challenge now is to take what we
Staff writers Brian cTavish and
rizing her." said Mary Ellen
still be women.
reading to a child. Kilo said.
City's Stand for Children commit-
know in our hearts we should do
Luura R Hockaday contributed to
Brown. 1 communications profes-
That Cooper acknowledged is
in a daily basis we witness the
tee
and muster the will individually
this article
sor at the University or Missouri-
tough JCI to puil off.
TODAY
THE SUN
Section E
October 22, 1996
Doctor's orders
include reading
72 1996
Health: Pediatricians
side down for his mother to
see.
at St. Agnes Hospital
"Oh, 'I Am A Puppy," she
prescribe books as part of
says, reading the title. "So,
you are a puppy. huh?"
babies well-being.
It's all too much for Mar-
tin, who breaks out In gig-
gles, opens the book, holds it
By SANDRA CROCKETT
over his head with two chub-
SUNSTAFF
by hands and toddles off
down the hallway as fast as
Martin McCoy stands be-
his legs will allow.
fore a bookcase just able to
Martin doesn't realize
peek over the first shelf.
he's at his doctor's office and
The 17-month-old toddler
this isn't supposed to be fun,
Is usually energy In motion,
especially since he Is due for
but a colorful case of books
a shot. But the book Is part
has his full attention now.
of the doctor-prescribed
"You get to choose one."
treatment in the pediatrics
CHIAKI KAWAJIRI
his mom tells him. "Go
department at St. Agnes
Checkup: Volunteer Nora Lanier, a secretary at St. Agnes, a reads to Jeffrey Joynes, 3, in the
ahead, let's get one you
Hospital.
hospital's pediatrics department.
want."
The Baltimore hospital is
The sweetly round-faced
the first in Maryland to use
a national organization dedi-
ter. In fact. Michael G.
"We were 21st on the wait-
youngster considers his op-
the "Reach Out and Read"
cated to improving chil-
Burke, chairman of the St.
ing list," Burke says. "We de-
tions and then plucks a book
program. The program,
drens' lives.
Agnes pediatrics depart-
cided not to walt. We wanted
from the lowest shelf. "Lets
which is In more than 30 hos-
St. Agnes decided to
ment, was so Impressed that
to do something with literacy
see what you got," says his
pitals around the country,
adopt the program in Sep-
he wasn't willing to wait for
this year."
mother, Danyel McFarlane.
receives funding from the
tember after seeing it in ac-
funding from the Casey foun-
The hospital started Its
Mar In holds the book up-
Annie E. Casey Foundation,
tion at Boston Medical Cen-
dation.
program by [See Books. 4E1
CHIAKI
Happy reader: Danyel McFariane. left. and Dr. Susma Vaidya enter-
tain McForianc's 17-month-old ann Michael MeChu
Doctors prescribe
reading to children
1Books. Page 1E)
In Boston, parents who have
had contact with the "Reach Out
gathering about 1,000 children's
and Read" program are four times
books through a "gently used"
more likely to list reading as an ac.
book drive and training a cadre of
tivity that they share with their
volunteer readers.
child than parents who haven't.
The Idea is to get kids and par-
Burke says.
ents into reading as early as possi-
"One of the roles of a pediatri-
bie - long before they start
clan is to give parents guidance on
school. Research shows conclu-
how to promote the health and
lively that reading to a child. be.
well-being of their child We are
ginning at an early age. provides
just expanding the definition of
educational and emotional bene-
the child's well-being to include
nts. A national 1985 Commission
literacy promotion," he says.
on Reading determined that read.
McFarlane. mother of little
ing aloud is the best way to help
Martin. was already reading to her
chudren develop literacy skills
son but likes the Idea of getting
"What we are realizing is that
the reading prescription.
we get to see kids. more than any
She believes children. particu-
other professional. before they
larly when they are a little bit older
start going to school." Burke says.
than Martin. will be Impressed
"Part of what we do on these visits
with the prescriptions. "1 think
is to tell parents what to expect.
this will definitely help the kids
We have always traditionally ad-
want to read." she says
vised them to do things like place
But books, especially those for
covers on plugs. and on the use of
the very youngest children. are
smoke detectors."
running low. "Right now. we are
How it works
looking for grants for books from
foundations. Burke says Also.
Now' St. Agnes pediatricians
they are approaching publishers
"prescribe" reading to children
and organizations such as the As-
when they come in for their well
sociation of American Publishers
baby check-ups. Here's how the
to inquire about discount prices.
program works:
The hospital could also use more
After the parent and child sign
reading volunteers who are willing
in at the desk. they go to a cheer-
to give up one or two hours a week
ful. dark green carpeted waiting
of their time.
room. A volunteer reader sits on a
The volunteers
slightly elevated stage area and In-
vites the child (if she's old enough)
Nora Lanier. a secretary at St.
to choose a book from her large
Agnes. is one of the 20 or so volun-
wicker basket. The volunteer en-
teers in the "Reach Out and Read"
tertains the child with a story until
program. Volunteer readers are
it is time to go in the back and see
trained to be an example to par-
the nurse.
ents on how to read to their chil-
Then. on the way to the nurse.
dren. and Lanier demonstrates
the child is allowed to select a
stellar qualifications for the task
book from the bookcase. The
She was able to earn the attention
books are grouped on each of the
- no small feat - of 3-year-old
four shelves by age group. The
Jeffrey Joynes.
child takes the book. now affixed
Lanier gets down on the Поог
with a paper bookplate with his or
and makes eye contact with
her name on It. into the examining
Jeffrey. who is waiting to see his
room while she is seen by the doc-
doctor.
tor.
"I've been sitting here and I am
The final stop is back at the
50000 lonely. I need someone to
desk where the child's parent
read a story to. Which book do you
makes a future appointment date
want me to read?" Lanter shows
and is given any necessary pre-
Jeffrey her wicker basket of books.
scriptions, including a prescrip-
The child. who is in the waiting
tion to read a book every day.
room with his mother Jackie,
There are different prescrip-
looks over at mom and apparently
tions for different age groups. For
is torn between sitting next to La-
instance. the "Reach Out and
nier or making a run for it.
Read" prescription for children 12
"Pick out a book," Mom coaxes
months to 18 months (complete
him.
with the hospital's logo on it) says:
He chooses a book. but it is
"Name the objects on the page
tough going initially. Lanier delves
and talk about them. Let your
into the story about a confused
child hold the book and help you
bird looking for his mother. She
turn the page. Read to your child
points to pictures. pauses from
every day approximately 5 to 10
her reading to ask the child ques-
minutes."
tions. raises and lowers the pitch
The prescription for children
of her voice. and. finally. Jeffrey is
ages 5 through 7 says: "Encourage
hooked Into the story.
your child to 'read' to you and tell
"Where's my mother?" Lanier
you the story. Take your child to
reads a line from the book.
get a library card and choose the
"Right there!" Jeffrey responds.
books you will read together.
pointing to a picture on the page.
When your child is ready. encour-
Another satisfied customer.
age letter and word recognition."
New or gently used children's
Burke doesn't know vet wheth-
books may be sent or taken to St.
er parents will follow the prescrip-
Agnes Hospital's pediatric de-
tion. but he thinks the prognosis
partment at 900 Caton Ave., Balti-
for the program is good.
more. Md. 21229
BOKS
Book
wills
IIIIIIII
Bokel CAON
THANK
©
/
IIIIIIII
Books!
Books
0
!!!!))!!
PRESCRIPTION OR READING
PRESCRIPTION FOR READING
Date
Date
Child's Name
Child's Name
What to do:
What to do:
Share a book with Your Child
Share a book with Your Child
Every night at bedtime
Every night at bedtime
For
minutes every day
For
minutes every day
Other ideas:
Reach Out and Read
Printed courtesy of Mosby. Banta Co., Lindenmeyer Co, and Penntech.
Other ideas:
Signature
Signature
Reach Out and Read
Printed courtesy of Mosby, Banta Co Lindenmeyer Co., and Penntech.
Reach Out and Read
Reach Out and Read
Reach Out and Read
Reach Out and Read
PRESCRIPTION FOR READING
PRESCRIPTION FOR READING
Date
Date
Child's Name
Child's Name
What to do:
What to do:
Share a book with Your Child
Share a book with Your Child
Every night at bedtime
Every night at bedtime
For
minutes every day
For
minutes every day
Other ideas:
Reach Out and Read
Printed courtesy of Mosby, Banta Co., Lindenmeyer Co., and Penntech
Other ideas:
Signature
Signature
Reach Out and Read
Printed courtesy of Mosby. Banta Co., Lindenmeyer Co., and Penntech.
Reach Out and Read
Reach Out and Read
Reach Out and Read
Reach Out and Read
Children's
National Medical Center.
Serving Children and Their Families Since 1870
111 Michigan Avenue, N.W.
Reach Out and Read
Washington, D.C. 20010-2970
(202) 884-5000
A Pediatric Program to Support Early Literacy Development
Overview: The Reach Out and Read program began at Boston City Hospital in 1989 as a way to encourage literacy development in
young children living in economically disadvantaged communities. Children's National Medical Center will be implementing the
program in January of 1998. Many of the families who receive their primary health care at our site are struggling to raise their
children in the face of severe medical and social risk. Research has shown that children from socially disadvantaged homes are at risk
for reading failure, which contributes to school failure and may ultimately keep those children in the grip of poverty. As part of
providing complete medical care to inner city children, the health care providers at Children's Hospital are committed to offering
families medical and developmental resources to help them break the deadening cycle of poverty and educational underachievement.
The Reach Out and Read program improves literacy among these at-risk children by providing their parents with the tools and
support they need to help the children to literacy and school success.
The problem: A 1993 Department of Education study estimated that over 40 million Americans are functionally illiterate. In adults,
illiteracy correlates with welfare dependency and poor earning potential; in children, it is associated with school failure, juvenile
delinquency, and teenage pregnancy. According to the National Commission on Reading's 1985 report, reading aloud by parents is
the single most crucial factor in children's later reading success. Many parents do not realize how important they can be in helping
their children; others know that reading aloud is important, but are not sure how to proceed, especially with young children.
A solution: The Reach Out and Read Program gives parents of at-risk children the information, encouragement, and material they
need to make books part of their children's lives. The program integrates parent education about literacy development into regular
pediatric care for children from birth to five years of age. At Children's Hospital, our primary health care site serves more than 500
children per week with a very large proportion coming from low income families. Statistically, these children are at a higher-than-
average risk of reading failure. We are well positioned to address literacy development, and to do it successfully because of our
unique relationship with the children and families we serve. In most cases, the relationship begins during the time in a child's life
when the foundations of literacy are laid, long before the child is ready for school or Head Start programs.
The program: The Reach Out and Read program has three components: reading aloud to children in the hospital waiting room,
incorporating an age-appropriate book into the pediatric health care visit, and finally, inviting the child to take that book home.
Through these activities, we show children and parents that books and book activities "feel good". Modeling reading behavior for
parents stresses the core activities in reading aloud: being together, talking with the child, and becoming comfortable with books.
Volunteer readers are trained by the hospital and taught about the developmental milestones of early literacy. These volunteers come
to the outpatient waiting room, set out a display rack of children's books, and engage young patients and their siblings in reading
activities. The volunteers don't simply read aloud; they interact with the children, encouraging them to identify pictures, add their
own experiences, and create new stories around the one being read. They encourage older children to read to younger ones, and
answer the questions of other family members.
The doctors and nurses make sure that each patient from birth to five years of age receives a developmentally appropriate book at
every well child visit, and that the parent receives information about the importance of reading activities. Because the medical staff
know their patients well, they are able to select books tailored to each child's need. The health care provider presents the book to the
young patient and caretaker, looks through it with them, and comments on how the child's interaction with the book relates to the
development of motor skills, language socialization, and autonomy. The professional may also use the book as a tool in the
assessment of the child. Finally, the staff will inscribe the book with the child's name and a short message.
Program budget: The total cost of the Children's Hospital Reach Out & Read program is $20,000 per year, primarily for book
purchases and staff support. The books we give to children are carefully selected, with guidance from physicians, educators, and
reading specialists, to meet our patients' developmental needs. For this reason, we are seeking donations in philanthropic support to
allow us to purchase selections from the program's approved booklist.
Please contact us with any questions regarding the Reach Out and Read program.
Sandra Cuzzi, M.D. (301) 754-7242
Brenda Shepherd-Vernon, M.S.W. (202) 884-5214
Key players in the Reach Out and Read program:
Co-directors:
Sandra Cuzzi, M.D.
Brenda Shepherd-Vernon, M.S.W.
As you probably already know, each Reach Out and Read program has its own unique style to
reach the group of children in its community. We have kept the program's focus on the preschool period
but have extended the start to the first newborn visit. More and more, we are finding that children have the
capacity to learn at younger ages. We no longer recommend starting to read to children at the age when the
child may learn to read himself. Rather, early exposure provides stimulation for brain development and
growth. By making parents feel comfortable with books at the very start of their child's life, we hope to
encourage the reading process early.
DC Public Library:
Maria Salvadore
Pam Stovall
They have volunteered their time and have been instrumental as educators in both childrens' book
selections and volunteer training for the Children's Hospital Reach Out and Read program. Pam already
has a Reach Out and Read program in place which focuses on licensed home child care providers in the
Washington DC area. They are also both involved in a family literacy project with incarcerated individuals
and teach about child development and behavior through books and literacy building activities.
Volunteers:
The most important group in the effort to bring books into the lives of children are the volunteers.
They model reading behavior and allow parents to feel comfortable sharing a book with their children.
Hopefully by providing a role model and encouraging the parents' literacy efforts we can show children
and parents that books and book activities "feel good".
First Book Distributors:
First Book has provided books through publishers at a significantly discounted rate, allowing us to
purchase more books for the many children in our community. By centralizing this process, they have both
facilitated the logistics and reduced the costs.
Reach Out and Read
Children's National Medical Center
Book Selection
Age
Title
Author
Publisher
Two weeks
Tickle, Tickle
Helen Oxenbury
Simon and Schuster
All Fall Down
Two months
Max's First Word
Rosemary Wells
Dial
Four months
What color? Que color?
Alan Benjamin
Simon and Schuster
Six months
Mommy and Me
Neil Ricklen
Simon and Schuster
Nine months
Baby's Zoo
Neil Ricklen
Simon and Schuster
Twelve months
Tomie's Little Mother Goose
Tomie de Paola
Putnam
Go Dog Go
PD Eastman
Random House
Fifteen months
Good Morning Baby
Cheryl Willis Hudson
Scholastic
The Very Hungry Caterpillar
Eric Carle
Scholastic
Eighteen months
Chicka Chicka abc
Bill Martin Jr.
Simon and Schuster
Let's Go Home Little Bear
Martin Waddell
Candlewick Press
Two years
The Little Red Hen
Paul Galdone
Houghton Mifflin
Freight Train
Donald Crews
Scholastic
Three years
The Snowy Day
Ezra Keats
Scholastic
Jamaica Tag Along
Juanita Hewill
Scholastic
Noisy Nora
Rosemary Wells
Scholastic
Four years
So Much
Trish Cooke
Candlewick Press
Corduroy
Don Freeman
Scholastic
Loving
Ann Morris
Scholastic
Everybody Cooks Rice
Nora Dooley
Scholastic
Five years
Bread, Bread, Bread
Ann Morris
Scholastic
Abiyoyo
Pete Seeger's Storysong
Scholastic
Leo the Late Bloomer
Robert Kraus
Scholastic
Amazing Grace
Mary Hoffman
Scholastic
12/15/1997 16:17
6175347557
PAGE
02
Reach
out
and
Read
REACH OUT AND READ (ROR) PROGRESS
(Since Prescription for Reading 4/97)
Barry Zuckerman, M.D.
Professor and Charman of
170 Reach Out and Read sites in 39 states serving over 500,000 children
Pediatrics
Boston Medical Center
2 million books have been distributed to 1 million children at hospitals,
Founding Director
health centers, and pediatric offices throughout the United States
Reach Out and Read
4,000 pediatricians and nurse practitioners have been trained in early
literacy development
ROR National Center has provided over $400,000 in grants to beginning
ROR National Staff
ROR programs since 4/97
Scholastic has donated 125,000 books
Perri Klass. M.D.
Medical Director
First Book has donated 100,000 books and devised a discounted book
ordering system for all ROR sites, involving 13 publishers
Christine Angell
American Booksellers Association distributed 200,000 free copies of
Nancy Berman
Read To Your Bunny to families via independent bookstores and donated
Pat Cowan, R.N.
remaining books from their convention in May
Elaine Grossman, M.Ed.
Dreyfus awarded funding to a local hospital, which served as a matching
Abby Jewkes. Ed.M
grant
Matthew Veno
Ronald McDonald House Charities awarded funding for books to ROR
Kate Williams
and First Book
Mellon Trust awarded funding for expansion at Boston health centers
Hasbro Foundation awarded funding for expansion in Alabama
Rhode Island Foundation awarded funding for expansion in Rhode
Island
Harris Foundation awarded funding for Chicago city-wide expansion
Casey Foundation awarded funding for Baltimore city-wide expansion
ROR programs in NYC have formed the first ROR City-Wide Coalition
Training session by ROR and plenary session by Barry Zuckerman, MD
at the American Academy of Pediatrics Annual Meeting in November
Partnership with National Association of Community Health Centers to
bring ROR to its 900 health centers
National Association of Children's Hospitals and Related Institutions
sent information on ROR to all its members
ROR is working with Reading Is Fundamental on a number of
collaborative projects in order to reach more children
Reach Out and Read
Boston Medical Center
One Boston Medical Center Place
Fifth Floor High Rise
Boston, MA 02118
Tel 617-534-5701
Fax 617-534-7557
First Lady Announces National Partnership to Prescribe Reading to Infants and Toddlers
April 16, 1997
"There are few things that I believe could make a more dramatic difference over the next 10 years in
this country than to persuade parents of all educational and economic levels to take this mission of
reading to and talking with their young babies seriously."
-- First Lady Hillary Rodham Clinton, January 10, 1997
New Partnership to Prescribe Reading and Ensure That Children Who Come to the Doctor Have
Access to Books. The First Lady is pleased to announce that a new national partnership has been created
to prescribe reading to infants and toddlers. Pediatricians, hospitals, health centers, book publishers,
libraries and others are coming together to make sure that infants and toddlers who come to the doctor
have access to books and are read to regularly. The American Academy of Pediatrics is recommending
that pediatricians prescribe reading to infants and toddlers as part of standard pediatric care.
The New Partnership Has Already Secured:
- More than 250,000 books to be distributed through health clinics and centers around the country;
- Commitments to train 10,000 pediatricians and 950 community health centers to prescribe reading
and provide books to hundreds of thousands of children by the year 2000.
The Partnership, Led by Scholastic Inc., First Book, and Reach Out and Read, includes the
American Academy of Pediatrics, National Association of Community Health Centers, National
Association of Children's Hospitals and Related Institutions, American Library Association, Random
House, Irving Harris and the Harris Foundation, Annie E. Casey Foundation, American Booksellers
Association, Association of American Publishers, Mellon Trust, Dreyfus Corporation, ABC Television,
Reading Is Fundamental, National Association of Chain Drug Stores, and the National Community
Pharmacists Association, and seeks additional partners.
Under the Reach Out and Read program, volunteers read to children in waiting rooms, health care
providers prescribe reading, use books in well-visits, and give books to children at the end of a visit. This
model program is already being used in more than 80 health centers and hospitals around the country.
Call to Ensure That by the Year 2000 Every Child Under Age Five Is Read to Regularly. The First
Lady is calling for every community to come together using its local library in partnership with local
health providers to help encourage reading to young children and ensure that every child under age five is
read to regularly by the year 2000. Today, only 39% of parents with children under three read to their
children daily [Commonwealth Fund, 1996]. Research shows that when doctors prescribe reading and give books
to low-income parents and their children, these parents are four times more likely to read to their children
[AMA, AJDC, 8/91].
Response to the President's America Reads Challenge and the First Lady's Call for a National
Effort to Prescribe Reading to Infants and Toddlers. Today's announcement is in direct response to
the First Lady's call in January for a national effort to build on the existing efforts to prescribe reading
by programs such as Reach Out and Read and the American Library Association's Born to Read and to
the President's America Reads Challenge to help parents be their children's first teachers and ensure that
every child can read well by the end of third grade.
The White House Conference on Early Childhood Development and Learning Will Underscore the
Importance of Reading to Infants and Toddlers. The White House Conference on Early Childhood
Development and Learning: What New Research on the Brain Tells Us About Our Youngest Children will
explore new research that shows that reading to children in their first few years actually helps their brain
to grow in addition to enhancing their emotional and social development and laying the groundwork for
vocabulary and later educational success.
VIEWPOINT
Hillary Rodham Clinton
Comfort and Joy
The First Mom suggests reading as an easy way to help a baby's brain grow
HE NIGHT AFTER THE INAUGURAL, BILL AND I GATHERED
ation and the American Library Association, a national
T
with our family in the solarium on the third floor of the
campaign to put books in the hands of parents who bring
White House. After dinner our toddler nephews Tyler
their young children to the doctor, and to get doctors to
and Zachary climbed up on the couch with their Uncle
prescribe daily reading. My husband and I will be dis-
Bill to hear him read a story. They accompanied him with
cussing this and other activities to follow up on the latest
words, sounds, pointed fingers and a few tussles over who
findings about the brain at a White House conference in
would hold the book. As I watched them, I thought of all the
the spring.
times Bill and I used to take turns reading stories to Chelsea.
It's important that we take to heart what the neuro-
Every night one of us (and occasionally both) would stretch
scientists are telling us-without losing the heart of the
out on her bed, hold her in our arms, and either read or
reading experience. In today's high-tech world of E-mail
make up new tales about imaginary characters who em-
and microchips, it is easy to forget the importance of hu-
barked on improbable but breathtaking adventures.
man connections in our daily activities. Technology has
Bill and I did not know about brain cells or synapses or
brought many welcome conveniences to our lives. But it
the newest discoveries in neuroscience. Reading to
has the potential to create feelings of distance, detachment
Chelsea became a daily ritual because it's what our own
and isolation among us.
parents and grandparents had done with us, and because
Reading to a child while touching, hugging and hold-
we wanted to spend quiet time with her every day. Bill's
ing him or her can be a wonderful antidote to the im-
grandmother thought that
personal tendencies of the
reading to him would help
information age-for both
him develop a strong vo-
the adult and the child.
cabulary and the language
While critical to building
skills he would need later
brains, reading is equally
on in school. My mother
important to building
and father placed a similar
trusting and close relation-
premium on reading, and
ships. That's why many of
to this day I remember the
us remember the warm
feelings of security and
embrace or the comfort-
comfort that I felt sitting in
able lap that cradled us
my grandfather's lap when
when we read books as
he read stories to my
children. And that's why
brothers and me.
reading should not be
Today, thanks to ad-
viewed solely as an intel-
vances in brain research,
lectual proposition, par-
we know that reading with
ticularly in the era in
a child has intellectual,
which we now live.
emotional and physical
benefits that can enhance
Mrs. Clinton with her daughter in the crucial first three years
If Americans take away
only one lesson from these
the child's development. The intimacy of sharing books
exciting scientific discoveries, I hope it's that reading to
and stories strengthens the emotional bonds between a
children is easy, affordable and feasible for parents no
parent and child, helps a child learn words and concepts,
matter what their level of education or economic station in
and actually stimulates the growth of a baby's brain.
life. Children's books are available for free at public
As I discussed in my book, It Takes a Village, scientists
libraries in every community and can be found at reason-
have discovered that children whose parents read and talk
able prices in many bookstores. Doctors, librarians, teach-
to them during the first three years of life create a stronger
ers, book publishers, business leaders and the news media
foundation for future reading success. In other words,
can help make books available to families and educate
what our parents and grandparents knew instinctively is
parents about the vital role that reading plays in our chil-
now backed up by hard scientific evidence.
dren's lives.
That's why doctors and nurses are starting to pre-
It isn't very often that we have before us such a simple,
scribe reading to babies along with regular checkups and
inexpensive and pleasurable way to improve our children's
vaccinations. Recently I went to Georgetown University's
health and development and raise their prospects for a
Medical Center with Maurice Sendak, the renowned
brighter future. Whether you lie down together on the rug,
children's author and illustrator. His book Where the
sit together in an old rocking chair or cuddle on your
Wild Things Are was one of Chelsea's-and Bill's-fa-
child's bed the way Bill and I used to with Chelsea, there
vorites. Mr. Sendak read the story to children, and I an-
is no better way to spend time than reading to your child.
nounced, along with representatives of the American
And now we also know that there are few better ways
Academy of Pediatrics, the American Booksellers Associ-
to help your baby's brain grow.
TIME, FEBRUARY 3. 1997
63
HILLARY RODHAM CLINTON
REMARKS AT CHILDREN'S NATIONAL MEDICAL CENTER
WASHINGTON, DC
DECEMBER 15, 1997
Thank you so much for honoring me with this award. I'm delighted to once again have
the chance to visit Children's National Medical Center.
Children's hospitals have always played a special role in our country -- and they have
always held a special place in my heart. When Bill and I were still in Arkansas, I served
on the board of Arkansas Children's Hospital. I learned then what all of you know: For
children's hospitals to thrive, it takes individuals who, day in and day out, dedicate their
hearts and minds to getting the job done. Individuals who. despite the obstacles, refuse
to ever give up. That's what the Children's National Medical Center has done for 127
years. And for that, all of us -- inside and outside of government, inside and outside of
Washington -- owe you our thanks and our admiration.
I want to especially thank those of you who are playing a leadership role in making this
hospital a part of our Prescription For Reading Partnership, which I announced earlier this
year. It is bringing together pediatricians, hospitals, libraries, and others around the
country -- just as you will be doing with your Reach Out and Read Program -- to
encourage and enable more parents to read to their children.
I'd like to acknowledge the two co-chairs of this extraordinary effort at Children's, Dr.
Sandra Cuzzi [koo -- zee] and Brenda Shepard Vernon, each of whom has been
instrumental in bringing the Reach Out and Read program to life. Thanks to the
dedication of these two women, along with the D.C. Public Library and SO many other
people here at Children's, new parents will be sent home with one of the most powerful
medicines of all: A Prescription to Read to their newborn children. I'm pleased to hear
that nurses and volunteers will be reading to children while they are in waiting rooms,
making a book a part of every pediatric visit, and then giving the child the chance to take
that book home.
When it comes to improving the fate of children in America, we all have a lot to be
thankful for this holiday season. Childhood immunization rates are at an all time high.
Infant mortality rates are at historic lows. And the balanced budget agreement the
President signed this past August includes an unprecedented $24 billion to help provide
health insurance to millions of children who don't know have it. That's the largest
investment in children's health care in more than 30 years. With this new initiative, we
now have the opportunity -- and the ability -- to take a major step forward in ensuring that
all children can live up to their God-given promise. I know all of you will work hard to
meet this challenge -- just as you have always done whenever the health of our children
has hung in the balance.
Benton Foundation
December 12, 1997
Ms. Nicole Ravner
The White House
OFFICERS AND DIRECTORS
Washington, DC 20502
President and Chairman
Dear Ms. Ravner:
CHARLES BENTON
Public Media Inc.
As you suggested, I am sending you some information on the Benton Foundation's
Treasurer
KidsCampaigns web site (www.kidscampaigns.org) We understand that the First Lady
HENRY M. RIVERA
is focusing considerable attention on the issues of foster care and adoption, and
Cinsbing Feblman. and Bress.
Charrered
KidsCampaigns is now devoting an entire section to this important issue.
General Counsel
As you may know, KidsCampaigns is designed to spur Americans to take action for kids
MARK LEOYD
Center for Strategic Communications
in their communities. This action can take many forms, from volunteering and
mentoring, to joining a children's group. KidsCampaigns already has an established
SCOTT W. BENTON
relationship with the White House web site; the White House site linked to
KidsCampaigns as part of the President and First Lady's appearance in the Ad
HAROLD RICHMAN
Chapin Hall Center for Children
Council/Coalition for America's Children public service ads earlier this year.
TERRY TINSON SAARIO
KidsCampaigns features in-depth information on a variety of important children's issues.
JORCE REINA SCHEMENT
Most recently, we have teamed up with the Casey Family Program and the Casey Family
Pennsylvania State University
Foundation to develop content on the many complex issues surrounding foster care and
adoption. The content, which explores such issues as how to adopt foster children, was
PAGE SIMON
Somhern Illinois University
developed in collaboration with The Foster Care Project's national awareness campaign
at Carbondale
and to coincide with a new public television documentary, Take This Heart. The film,
produced by KCTS/Seattle, is the true story of a dedicated foster mother and the boys
LINDA TARR-WHELAN
Center for Policy Alternatives
currently in her care. The film is scheduled to air on PBS stations in early January, 1998
with production funding provided by The Casey Family Program and The Annie E.
Trustees
Casey Foundation.
CHARLES BENTON
MARJORIE C. BENTON
LEONARD SCHRAGER
We would be happy to provide a briefing to you and any other staff you feel would be
appropriate on The Foster Care Project, and in particular the foster care content featured
Executive Director
on KidsCampaigns. In addition, we would be honored if Mrs. Clinton would consider
LARRY KIRKMAN
referring to the web site content and the video as she talks about this critical issue.
Deputy Director
KAREN MENICHELLI
To find the foster care section of KidsCampaigns, simply log onto the home page, then
click on "Take This Heart: The Foster Care Project."
Finance and Administration
SANDRA N. BERLIN
Please do not hesitate to contact me should you need any further information.
Children's Programs
SUSAN NALL BALES
Sincerely,
Communications Policy
ANDREW BLAU
Janua weirs
Media Production
Laura Weiss
DAVID WEINER
Senior Associate
1634 Eye Street NW Washington DC 20006
Telephone 202 638 Fax 202 638
Email [email protected] WorldWideWeb www.benton.org
Boston Globe
For children's good health,
10/27/96
a book at every check-up
He came for a physical recently and we
PERRI KLASS
checked his lead level, since as a toddler
in the inner city he's at high risk, and
his week Boston will play host
checked for anemia. But he didn't seem
T
to the annual meeting of the
to have needles on his mind.
American Academy of Pediat-
"Want book!" he yelled to me with
rics, the professional. organi-
2-year-old intensity. "Want book!" I
cation that speaks for pediatricians,
gave him a board book at his 18-month
tests us and/certifies us, sets our stan-
visit (along with his fourth DTP shot),
iards of medical practice to keep up
another when he was 15 months (Hae-
with changing times.
mophilus influenzae shot) and another
But the pediatric innovation that my
when he was one year (measles-
collegues and I will be demonstrating at
mumps-rubella). And SO on, way back to
he meeting, the Boston-bred innova-
the 6-month-old checkup. That's six
ion we hope will diffuse out through
books already; there'll be at least four
ediatric clinics around the country, has
more before he starts school.
nothing to do with wonder drugs or fi-
Reading success starts well before
er-optic miracles. We want doctors to
school and formal reading instruction,
rive books to their voung
and
atients.
learn to love books and to
A decade ago, it
It's called
understand that books
asn't part of a pediatri-
contain stories and infor-
ian's job to give out
'a light in the
mation. A 1995 analysis
ooks. But then, formal
darkness.'
that statistically exam-
ssessments of develop-
ined 29 empirical studies
BOB DAHM ILLUSTRATION
:ent and language
of the effects of parents
and educators. "The first time I gave a
ert Needleman, carried out in the pedi-
eren't part of a pediatrician's roie at
reading aloud to toddlers and pre-
1-year-old a book as part of a pediatric
ne time, either. Now we teach develop-
schoolers concluded that essentially all
atric clinic at Boston City Hospital, par-
visit and saw the child's eyes light up,
ents whose child had received a book at
ental assessment as part of the stan-
studies showed a pronounced positive
and saw the mother smile in response
ard pediatric exam. If, along with giv-
effect on outcome measures of language
a previous visit to the clinic were four
to her son's excitement, I knew I had
g shots and handing out safety advice,
growth, emergent literacy and reading
times more likely to report reading
found a special way to touch a child's
e haven't checked to see if a child is
achievement. The positive effects of
aloud to their children. For families on
life." says Dr. Barry Zuckerman, chair-
:quiring spoken language, then we
reading to preschool children were in-
AFDC, the association was particularly
man of the department of pediatrics at
wen't done our job.
dependent of socioeconomic status or
Boston Medical Center and one of the
marked: if they had received a book,
The next step is written language.
parents' educational level.
founders of Reach Out and Read. "I be-
parents were eight times as likely to re-
arly literacy. Just as spoken language
Last week I saw a child I worry
lieve it has as much or more impact on
port reading to their children.
arts long before a child learns to talk.
about. He's one year old, born with
the child's future as anything 1 do as
Pediatricians are trained to think in
eracy starts developing long before a
drugs in his system. the youngest of six
part of preventive care."
terms of prevention. Give the MMR
ild actually begins formal reading in-
children in a family that is struggling
The goal of the program is to make
and we don't have to treat the measles.
ruction. What happens in the years
hard. Mother in treatment. Maybe not
literacy part of regular pediatrics.
Free flu shots for children with asthma.
tween birth and kindergarten is ab-
always enough food. Hasn't grown very
Zuckerman's mentor was Dr. T. Berry
Growing up without books is grow-
jutely essential: Children either start
well. Hasn't really developed on sched-
Brazelton, now a member of the adviso-
ing up deprived and with a deprivation
hool liking books and understanding
ule. But he looked good. finally putting
ry board of Reach Out and Read. which
that puts one at risk for failure. Just
nat they are or they start school way
on weight, making some developmental
he calls "a light in the darkness."
like many of the other risks and depri-
hind, set up for failure.
progress. though delayed for his age.
A book at every checkup from six
I gave him a board book full of
vations that children face in poverty,
Mayor Thomas Menino's Read Bos-
months to five years. At Boston Medi-
n literacy initiative. now one year old.
bright photographs of children playing,
growing up without books is a sad loss
cal Center. we will give away our
ins to have all children reading by the
and his mother and I watched him grab
in itself, but also a risk factor for larger,
100.000th book this fall. If it costs $3 to
ed of third grade. Pediatricians and
it. "I know you're busy," I started. and
S4 for a book. and if every child sees the
sadder losses. Double jeopardy. If we
rly-childhood educators have been
she beamed. "The older ones will read it
doctor 10 times between the ages of 6
want our children to grow up reading,
It of this initiative from the begin-
to him." she said. "They always read
months and 5 years. then these books
we have to do everything possible, and
ng because this is not only a school
him that book you gave him last time."
cost $30 to $40 a child. Less than any
we have to do it as early as possible.
oblem, it's a preschool problem.
The Reach Out and Read program
immunization or blood test.
Consider my 2-year-old patient,
was founded at Boston City Hospital
In a study by Zuckerman and an-
Perm Klass is a pediatrican at Boston
inmaal, a primary-care success story:
about eight years ago by pediatricians
other founder of the program. Dr. Rob-
Medical Center and Dorchester House.
REACH OUT AND READ
Volume 2 Issue 5
BOSTON MEDICAL CENTER
NOVEMBER, 1996
Since I'd planned to revisit my
thought my being there must be a
hometown, I brazenly called his office in
waste. And he did not interact with
INTRODUCTION
Lakeside Babies and Children's Hospital
me, indicate in any way, even by
by Pat Cowan
and was rewarded with an appointment
expression, that he was listening to my
for 15 minutes on July 22nd.
story or cared about my being there.
Dr. Needlman is astonishly young. I
I continued to read and after awhile I
"Hi, I'm Cynthia Weir," said the voice
wondered if he was still an intern;
could hardly believe my eyes as I saw
on the phone. Five minutes into our
athletic, handsome with curly brown hair
his tiny hand stretch toward me with
conversation I had learned that two hip
and attentive eyes, he seemed pleased to
considerable effort. He was reaching
replacements and "a little difficulty
hear about Boston Medical Center. He
out to touch me; my reading was not
walking" would be no hindrance to
immediately straightened me out, saying
an intrusion or an annoyance to him.
Cynthia's participation in Reach Out
the credit for starting Reach Out and
Receiving this wonderful gift, I was
and Read as a volunteer reader in the
Read belongs to Kathleen Fitzgerald Rice
overcome. But the important thing was
Primary Care Clinic. "A chair with
and Perri Klass.
to keep on reading and somehow I did.
arms is all I'll need, "and with that taken
Then I wept inconsolably in the car and
care of, Reach Out and Read and its
He gave me two short papers he'd helped
at home.
young patients and their families set off
write: Reach Out and Read: A Pediatric
on a reading adventure with Cynthia
Program to Support Emergent Literacy
I thought about Roberto a lot during
every Thursday morning. With vitality
with Kathleen Fitzgerald Rice and Fight
that brief time and made other trips to
and enthusiasm, she engaged each child,
Illiteracy, Prescribe a Book with Barry
the hospital specifically to see him.
marveling always at their brightness and
Zuckerman, M.D. He was called away
Each time he was sicker. His
beauty. A woman of grace, she was able
by "a child who is crying" but I really
breathing was terribly labored. I
to communicate with mothers and
appreciated meeting him and feel his two
couldn't imagine how or why a little
fathers as a fellow parent. For us she
papers, which can be read in half an
child could endure so much agony.
was a delightful lunch companion,
hour, will delight all who volunteer for
regaling us with stories of horseback
Reach Out and Read."
It was clear Roberto wouldn't live
riding in her home state of Colorado
much longer. His death, I was told,
and college hi-jinks at Vassar in the mid
Cynthia Weir, ROR Volunteer
affected many people at the hospital
1930s. Most often she spoke of her
deeply. I think that must be a great
family-her four children,
comfort to his family, to know that a
grandchildren, and great-grandchildren.
A VOLUNTEER'S STORY
little one who bore suffering so
bravely-and who could still reach out
Cynthia died unexpectedly on October
when he could experience no joy-made
19, 1996. She will be greatly missed by
JoAnn Fitzpatrick
such a powerful impact.
all of us at Reach Out and Read.
Hardly a time goes by when I visit
Sometimes readers think their time is
She wrote the following after an
Boston Medical Center as a Reach Out
wasted. The children are into games,
interview with our founder, Dr. Robert
and Read volunteer in Pediatrics that I
cartoons or videos. They don't always
Needlman, at Rainbow Babies and
don't think of Roberto.' It was almost a
indicate they are glad to hear a story.
Children's Hospital while visiting
year ago, during a few beautiful fall
Many times, of course, they do and
Cleveland in July:
weeks, that I met the tiny boy lying so ill
enthusiastically. But on those days I
in his hospital bed. I was new at this and
wonder if reading a story has any value
"As a volunteer for Reach Out and Read
more than a little scared of a small child
at all, I remember Roberto.
who looks forward all week to
who looked so sick.
Thursdays on the fifth floor, I was eager
*Name & identifying details have been
to meet the founder. I gathered Dr.
A nurse pointed me toward Roberto's
changed.
Robert Needlman, a pediatrician,
room and I sat by the bed to read to him.
recently moved to Cleveland, Ohio, had
He looked so distracted, so removed by
done it all.
what I assume was pain, that I first
2
REACH OUT AND READ
PRESCRIPTION AT TRI-
NEWS FROM NEW ORLEANS
HEALTHY KIDS FAIR
RIVER IS AN OPEN BOOK
Ellen Beyer writes:
Pat Cowan
Thomas Mattson
ROR Program Coordinator
June 11, 1996 at the Association for the
The following is an edited version of a
Care of Children's Health, a Reach Out
recent article in the Blackstone Valley
and Read team presented the program.
Boston Medical Center hosted the
Tribune.
The title was, "I'm a Reader, I Can Be
second annual Healthy Kids Fair on
Anything: Supporting Children's
September 10, 1996 attended by 1500
Doctors are going to have to start writing
Literacy Development in Pediatric
area children and sponsored by United
out prescriptions with a scrawl that is a
Practice." The participants were Julia
Way, Bank of Boston and the local ABC
little more readable.
D. Grimes, Co-Director, ROR New
TV affiliate. These preschoolers from
Mexico, Child Life Program; Meloney
Head Start, ABCD Day Care and
Because it will be parents and small
Baty, Co-Director, ROR New Mexico;
Associated Day Care, plus
children reading them, not pharmacists
Ellen Beyer, Co-Director, ROR New
kindergartners and first graders from
practiced in the intricacies of physician-
Orleans; Mareth Williams, Medical
Boston Public Schools were bussed by
scrawl.
Director, ROR New Mexico; Rebecca
Blue Cross/Blue Shield to the event.
Kazal, ROR Ganado. We had
Participants included the local PBS
The new scenario will soon come about
approximately 25 attendees.
affiliate, HealthNet Neighborhood
at Tri-River Family Health Center on
Health Centers, and the Boston Police
Hartford Avenue. That is because
Daisy Troop 98 in New Orleans made a
Department. Activities involving
volunteers like Julie Woods and a
quilt of the months of the year and
nutrition, fitness and scrub suit dress-up
nucleus of doctors and medical students
donated it to the ROR program. It is
were popular.
see reading as a primary skill that also
now framed and hung in the Pediatric
helps a mother and child strengthen their
Clinic at Charity Hospital for all to
Reach Out and Read invited eight
emotional needs.
enjoy.
celebrity readers, including the wife of
our mayor, a TV news anchor, and the
Woods became a disciple of the project
July, 1996, we hit our 500 mark per one
superintendent of Boston Public
when she reflected on what she could do
month. To date we have given out 5868
Schools. A solid wall of balloons
to express her gratitude for the early
new books.
provided a colorful back-drop for our
diagnosis a Tri-River pediatrician made
reader rocker which was placed on a
of her young son's cancer.
August: Ivanhoe Productions
bright dinosaur rug. Scholastic Big
interviewed the ROR staff and visited a
Books such as Three Billy Goats Gruff,
"We had just moved here from
family in their home. We were then
The Little Red Hen, and The Very
Leominster," Woods explained. "My
featured in the TV medical news
Hungry Caterpillar riveted the attention
son was four months old when Dr.
nationally. The viewing audience is a
of our young readers.
Jeffrey Lukas diagnosed our son as
projected 60 million. So far (as far as
having cancer. My son is two and a half
we know) we have aired in Chicago.
Twenty-five hundred books presented to
now and is doing well."
We received 18 phone calls regarding
the children were received with joy.
our program. This was great for our
Donations from Harper Collins to the
As she explained it, pediatricians,
national image.
Books for Kids Fund, plus books
because of their special relationship with
purchased at discounted rates from
families, are in a good position to help
Books For Kids generously donated
Troll, Golden Books and Early Learning
foster reading. They can do it by setting
over 1800 new books to our program.
made up the total figure.
up volunteer programs in the waiting
rooms.
Publicity and exposure for Reach Out
and Read at events such as this one are
The hope, according to Dr. Julie Meyers,
invaluable in spreading our message of
the pediatrician who is coordinating the
emergent literacy.
program at Tri-River, is that reading will
become a part of family life where it has
not been in the past.
The program acronym is START
(Sharing Together and Reading
can find Haven, Connecticut; Worcester, Massa- effective in improving boys' reading skills.
mmunity chusetts; and New Orleans, as well as a If these findings hold up as the-program
literacy Navajo reservation in Ganado, Arizona. continues, the intergenerational program
the In Cambridge, Massachusetts, 34 will offer a'significant benefit, since studies
are giv older persons volunteer as literacy tutors show boys experience more early failure in
in the school-based Intergenerational reading than girls.
ell-Child Literacy Tutoring Project. For the past, In the fall the project expands into the
(ROAR) two years, these retired citizens, rigor- Boston public schools, where anew group
olunteers
1
to see
also
an
with
ears.old
program
Richard
to his
demon-
that
dren.
In-
hat make
to
e doctor's
books to
lear mes-
teracy to
Dr.Perri
or of
d literacy
than
At Boston City Hospital Well-Child Clinic, Dr. Perri Klass reads with children as partof pediatric visits
and every child leaves with book Community volunteers read to children in the waiting room
tami-
brary by ously trained in helping poorh prepared of100 entor citizen.volunteen will tuto
Zucker- first-gra der improve their reading S MIN, firs with re. ding diff iculties."
ROSTER
Rad
CATCH Facilitators:
Luisa Alvarado-Domenech, MD
American Academy
Richard Aronson, MD
of Pediatrics
Louis Bartoshesky, MD
PEDIATRIC
Evelyn F. Baugh, MD
Jacalyn Blackwell-White, MD
Patricia Juarez Blanco, MD
Stephen Boos, MD
Jeffrey Brown, MD
Sarojini Budden, MD
Susan P. Bullard, MD
ATCH
Volume 4
Robert W. Chamberlin, MD
Issue 2
Sechin Cho, MD
Lou DiNicola, MD
Joe Donaldson, MD
Jean Fahey, MD
Charles Robert Feild, MD
Arnold Gold, MD
Alma Golden, MD
UARTERLY
Nancy Graff, MD
Frank Guilfoyle, MD
Robert E. Holmberg, Jr, MD
Gary K. Johnson, MD
Community Access to Child Health
Fall 1996
Steven Kairys, MD
Ronald Lindsay, MD
Jon Lyon, MD
Pediatricians Promote Literacy -
Carolyn McKay, MD
Linda McKibben, MD
A Storybook Program
Richard P. Nelson, MD
Elisa Nicholas, MD
by Christine Tatum
Roy Niimi, MD
Martin Nygaard, MD
When
she first handed out books to
watching the two other children usually
Yvette Piovanetti, MD
John R. Poncher, MD
young patients, Perri Klass, MD, FAAP,
chasing each other around the room."
Paul Qaqundah, MD
a pediatrician at Boston City Hospital, said
Dr Klass now maneuvers a storybook as
Barbara A. Quinton, MD
she was incredibly enthusiastic but com-
easily as a stethoscope. She is co-director
Marsha Raulerson, MD
pletely overwhelmed. "I always had this
of the hospital's well-established Reach
Mary E. Rimsza, MD
feeling of 'Don't let me forget," she said.
Out and Read program, funded largely by
Peter Simon, MD
"I was thinking about seeing all the people
the Annie E. Casey Foundation, the M. R.
Christina Smillie, MD
waiting, giving physical exams and shots,
Robinson Fund, and the Association of
E. Dawn Swaby-Ellis, MD
and assessing family dynamics. as well as
American Publishers. The program was
Mary Tait, MD
instituted approximately 6 years
Jean Takenaka, MD.
ago by chief of pediatrics Barry
Raymond Tervo, MD
Zuckerman, MD, FAAP, at Boston
Peggy Tolliver, MD.
City Hospital. It encourages the
Debra Tomek, MD
widely accepted practice of using
Denia Varrasso, MD
books and reading to assess a
Karl Wehner, MD
child's communication skills.
Wendell Wheeler, MD
About 30 other hospitals nation-
David T. Wong, MD
wide participate in the program.
Judy Wood, MD
Also, other hospitals and child
George A. Zirkle, Jr, MD
health care providers have their
District CATCH Facilitators:
own versions. Their common goals
are to teach parents and children
Bronwen Anders, MD
the value of reading and to spread
Olin Marion Burton, MD
the word to other pediatricians that
Rebecca Kirkland, MD
promoting literacy contributes to
Alan Kohrt, MD
better health care.
David Lohmeyer, MD
Ralph B. Moore, MD
Lessons regarding the value of
H. Burtt Richardson, MD
reading normally begin in the
Reach Out and Read. A volunteer at Boston City hospital
Calvin Sia, MD
reads to children in a pediatric waiting room.
(continued on page 6)
Gerald Tiberio, MD
CATCH QUARTERLY, Fall 1996
To learn more about
Pediatricians Promote Literacy - A Storybook Program
this program and how
(continued from page 1)
you can "reach out"
in your community,
waiting room, where volun-
Reach Out and Read esti-
attend the special
is being seen by the doctor.
presentation by Perri
teers or staff sit in a cozy corner
mates that it has given
"A pilot program that's
Klass, MD, and Barry
with a storvbook. They read,
away 75,000 books so far.
still in the works will focus
Zuckerman, MD,
point to pictures, and ask
The program has suggested
on teaching mothers to
m Reach Out and
questions many a wide-eyed
a list of age-appropriate
read." Dr Pita said. "Everv-
Read at the AAP
youngster is eager to answer.
materials and gives only
one has dignity and worth,"
Annual Meeting in
"That contact does at least
new books to its patients.
she added. "People feel more
loston. Look for log-
two things," Dr Klass said. "It
"We look for new books,
valuable to others and much
stical information
shows children that reading
beautiful books and clas-
better about themselves when
isted in the Upcoming
can be fun and interactive and
sics," Dr Klass said. "We
they know how to read."
vents section of
it models for parents how to
also select books that reflect
Wherever she goes, Dr Pita
his issue.
read aloud. I think it also
a variety of cultural and
makes it a habit to look for
makes for a nice atmosphere."
ethnic backgrounds."
books she can take back to
Once inside the examining
Another book giveaway
the clinic. Dr Pita said she
room, pediatricians give their
program offered by the
usually has good luck at
patients a book to take home.
Environmental and Health
garage sales and stores that
"When the book comes from
Services clinic in Dallas. TX,
carry discount books and
the doctor, it makes it a thing
has found help from a variety
teachers' supplies.
of importance," Dr Klass said.
of community sources. The
"Doctors who want to have
"It makes the kids proud and
program, largely funded
this program for their patients
it says to the parent, 'I believe
by a 5-year Healthy Tomor-
can do it very easily," she
in your child's potential as a
rows grant and directed
said. "Finding volunteers to
reader and a student.' Parents
by Alice Pita, MD, FAAP,
read is a piece of cake, and
need to hear that, especially
accepts books from libraries,
staff can be trained to do it
those parents who didn't have
churches, and anyone else
during slow times."
a particularly easy time in
who wants to give them.
Aside from investing in a
school or who weren't trained
"We had a 10-year-old boy
child's education, Drs Pita
to help their kids do better
come in here with 24 brand
and Klass agree that the
than they have."
new books, worth about
storytelling and book give-
Dr Klass incorporates the
$250," Dr Pita said. "He had
awavs are a boost for business.
gift into the physical exam,
just celebrated his birthday.
"It's a remarkable (public
for example testing gross
He told the friends who
relations) tool." Dr Klass said
motor skills by having a child
came to his party not to
with a chuckle. "We have
walk with the new book in
bring a present for him, but
people who call and want
hand, or testing fine motor
a book for us instead."
to know if they can have an
skills by having the voungster
Like Dr Klass, Dr Pita
appointment when the 'story
-turn a particular page. She
insists that health care and
ladv' will be around. "That's
might discuss with parents
literacy are inextricably
when we know we've gotten
who are concerned about
linked. "Without education
their attention." Interested in
their children's sleeping habits
and empowerment, people
learning more about Reach
the value of reading to children
aren't going to make good
Out and Read or in starting
before they go to bed.
health care choices," she said.
your own book giveaway
Given that children have
Dr Pita said her clinic's
program? Contact Perri
on the average 12 health care
book giveaway program
Klass, MD, at Boston City
visits between the ages of 6
does not just help young
Hospital, Dept of Pediatrics,
months and 5 years, Dr Klass
patients. Illiterate parents
Maternity 5, S18 Harrison
Read
said it is comforting to know
and siblings who are having
Ave. Boston, MA 02118, or
that they will have a small
trouble in school are also
Alice Pita, MD, Chief of
to
Child
personal library by the time
being identified and helped.
Pediatrics, Citv of Dallas
they start school. She esti-
Teams of volunteers from
Environment and Health
mated that the cost of 5
the local library meet with
Services, 214/670-8267.
years' worth of books is
older children to work on
Christine Tatum is a reporter
$30 per child.
homework and reading
and freelance teriter.
while a little brother or sister
Commentary
Books open up a world of choices and possibilities
by PERRI KLASS, M.D. FAAP
include literacy 111 then exams. dramming
"P community support. taising money "
We pediatricians like In think patients
buy books. and doing research on pedi
and parents remember our advice and Iry
atric fiteracy program impact.
our suggestions at home. We spend 50
The meeting was tull of the sense that
much of our days giving advice. trying to
pediatric literacy programs really work
smooth the future with anticipatory guid-
providing opportunities for pediatricians
once. reacting to patients' problems with
to make a difference.
the distilled wisdom of our experiences.
Louis Kazal. M.D. FAAP. IN the med
with the carefully thought-out polic of
our profession.
Reach Read! Out
ical director of Sage Memorial Hospital
simated on a Navajo reservation III Gana
01 course. some things we know they
do. Aiiz. His wile. Rebecca. direct is the
take home immunizations. for example.
Reach Out and Read program
But advice. even good advice, is much
"Tell pediatric that other people
more nebulous. It's hard for people to
want to work with them." said Dr. Kazal
change behavior patterns, to follow
describing the outpouring of support for
through on good resolutions.
the reading program.
And that's exactly why I love giving
Besides the many community members
children books. Like other pediatricians
who have vohnnteered to read, artist Her
who have incorporated books and literacy
erly Blacksheep painted a picture of
counseling into their well-child care. I
woman reading 10 three children and ..
know I am not only giving advice but also
lamb. The painting hangs III the Navajo
the means to the end. the tool. the essential
Nation Reach Out and Read Center.
you-must-have this-m-the-house talisman.
At the Medical Center of Louisiana. ⑉
I have to admit that when I started giv-
Good
New Orleans. a large and ambitions Read "
ing out books. I wasn't sure I would be
Out and Read program has been operating
able to work them into my primary care
for more than a year. Directed by Ellen
visits. Check-ups for young children are
Beyer. R.N., and Susan Berry. M.D
such basy times. hill of questions and
FAAP the program represents " wealth 111
parental concerns. notritional advice.
creative public 1811 areness and found-taising
behavior problems. salety ups. immunza-
ideas. from printing phone numbers .....
tions and tests
Make
Palambo
Medical
Center
of
procery trags for people to call to vohnteer
I found that it book can be used as it
Reach Out and Read volunteers read stories to children while they wait to see
time or donate books or money. to massive
developmental assessment tool: You
their pediatricians. The program exists in eight states: Connecticut, Ohio, New
book drives by Buy Scouts New Orleans
hand a board book to a 6-month-old.
Mexico, Massachusetts, Louisiana, Arizona, New York and Michigan.
Reach Out and Read theives within a boss
then see it he can SH insupported. get the
complex pediatric residency. because the
book to his month and hold his head
growing up without children's books.
favorites. 100 (More. Alone No. Said
residents so enjoy giving books to then
steady. ()₁. you band a book to a toddler
without being read to. and in fact. without
the Boy).
patients. according to surveys.
and see whether she can 1019 pages.
easy access to books. Bookstores don't
By pediatric standards, this IS not an
In tact. at all 12 programs. clubhen love
point and identify pictures.
exist in Boston's inner city. Many of our
expensive intervention: Buying books III
getting the books - and physic rais love
With the book. can also talk about lan-
patients grow up in families with limited
bulk. at publishers' discounts. means an
giving-them.
guage development. about bedtime
discretionary income. Some parents have
average cost of a book. II at bild has 10
"I wouldn't do it il it wasn't him." said
rontines I express my confidence that my
limited reading skills.
health supervision visits during the target
Laurel Shader. N.D. PAAP. who doests
patient will grow up to be a reader. to sue-
Reach Out and Read has thice com-
years, the price of a "full course" comes
the Reach Out and Read program at Fan
ceed in school. By handing out al book. I
ponents:
out to about $30 per child.
Haven community Health Center. in New
also show that I believe 111 the parent's
Volunteers in pediatric waiting rooms
For only $30. a child can know what it's
Haven, Com.
ability to help the child along that road to
read stories to the patients (and their sib-
like to grow up with books III the house. to
" " fun. " feels good: Il feels ngtht
learning and school success.
start school with a small home hbrary of
Reach Out and Read is a concrete contro
longs or friends) waiting to see the
The books I give out embody every
doctors This makes the waiting room a
picture books. to rear Is kinderg.
bution to children's well-being. As
thing I want for my patients and their
much nicer place. of course. but II also
knowing what books are for and, hopetul-
pediatricians know. growing up healthy
families: a wider world and the skills to
ly. associating them with parental love and
means much more than the absence of dis.
provides a model for parents: Books are
navigate ii. choices and chances and pos-
fun. not discipline. Reading with hil.
attention. II costs less than any blood test
sibilities.
does is happy in tive game.
we do. than any routine urine culture
Life without books
During health supervision visits. physi-
Gesture of faith
The Read Out and Read program was
clairs and pediatric norse practitioners
Since 1994. Reach Out and Read has
founded at Boston City Hospital some
dise HSS the importance of books and
been funded by the Anne E. Casey Form-
seven years ago. The program beg.n. as a
reading aloud We encourage brief. age-
dation, helping new Reach Our and Read
collaboration between pediatricians and
appropriate guidance for example.
babies like to look at pictures of babies.
programs get started in neighborhood
early childhood educators cluding
Toddlers like to hear the same stories
health centers around Boston. and in pedi-
Barry Zuckerman. M.D FAAP. now
over and over
anic clinics and teaching hospitals
Boston City Hospital's chairman of the
nationwide.
Department of Pediatries: Robert Needl-
At every health supervision visit from 6
In May. a special interest group in pedi-
111.111. M FAAP HOW assistant professor
months to 5 years, the pediatrician gives
atric literacy met at the Ambulatory
of pediatrics at Rainbow Babies and hil-
the child at book. Board books, colorful
Pediame Association/Society for Pediatric
diens Hospital in Cleveland, and Kathleen
and chewable. to the babies. For the
Research annual meeting in Washington,
Entzgerald Rice. M.S. Ed. now program
toddlers' thyming books soitable for
D.C Roughly 50 representatives hom
co-director.
bedtune repetition. Counting books and
Reach Out and Read programs nationwide
Frank Currendosion City Hospital
The idea of distributing books to
story books and alphabet books and
as well as other pediatric literacy pro-
Dr. Klass: "II's exciting to offer a child
encourage reading developed out of the
books about animals. Some old
grams discussed the logistics and
a beautiful book and watch II do its
realization that many of on patients were
lavorites (Good Night Moon) and new
complexities of training providers to
work, cast Hs spell."
14 AAP News/July 1996
A volunteer reads to children at the Medical Center
of Louisiana's Pediatric Clinic, in New Orleans.
case " means growing up with love and
Boston "ity Hospital. assistant professor
attention. and acquiring spoken and writ-
of pediatrics, Boston Univer Si Innol of
ten language.
Medicine: and pediatrician of Don hester
It's exciting 10 offer a child a beautiful
House. Boston. Fin information about the
book and wate " il do in work. cast its
Rene " Oill and Read Program. which has
spell. II a gesture of birth III the skills of
when III several major U.S. thies. contact
the parent, in the potential of the child.
either Dr: Klass or co-director Kathleen
Fitzgerald-Rice. Reach Out and Read
Dr: Klass has written Inc books and is "
Program. 818 Harrison Are MAT-5.
director. Reach ()nit and Read Program.
Boston. MA 02118; (617) 534-5701.
Make
Medical
Center
-
8
EDUCATION WEEK MAY 29, 1996
Curriculum
The program, which is aimed
chiefly at children in poor
communities, has three parts.
First, volunteers read aloud to
A trip to the doctor for many
children in the waiting room. Not
children means coming home
only do the youngsters enjoy it,
with an inoculation, a
Dr. Klass said, but it also serves
prescription, and perhaps a
as a model for parents who can
lollipop. Now, though,
see that children don't have to sit
pediatricians in some cities are
still or be quiet. "It also makes
presenting their young patients
waiting a lot easier, she said.
with books, as the profession
Second, in the examination
takes steps to include literacy in
room, doctors advise parents
its definition of a healthy child.
about reading aloud to their
"It fits well with other changes
children and explain what kinds
that have gone on in pediatrics,"
of books and behavior are
said Dr. Perri Klass, a
appropriate for their ages.
pediatrician at Boston City
Babies, for instance, like to put
Hospital and a co-director of the
cardboard books in their mouths,
hospital's pediatric primary-care
while toddlers like to be read the
clinic and its Reach Out and
same story-with lots of
Read program. "Pediatrics has
rhymes-over and over again.
been moving further and further
Finally, at every visit-from
away from just treating diseases
the time the child is 6 months to
of children."
5 years old-the doctor gives the
Under this expanded
youngster a book to take home.
definition, she said, a well child
Because Boston City is also a
is developmentally, cognitively,
teaching hospital, Dr. Klass and
and socially healthy, not just
her associates have made
physically healthy.
promoting literacy a part of their
Founded at Boston City
interns' education.
Hospital about six years ago, the
And they are trying to spread
program will be reproduced in
the word among those physicians
health-care centers and
whose practices are already
neighborhood clinics in nine
established. At the annual
areas across the country. Detroit,
meeting of the Pediatric Academic
New Orleans, New York City, and
Societies in Washington this
a Navajo reservation in Arizona
month, they held a Reach Out
are among the sites that are up
and Read session for doctors.
and running, and others are in
"My goal is that this should be
the works, Dr. Klass said. The
part of pediatrics, part of
Baltimore-based Annie E. Casey
pediatric training, and part of
Foundation has given $450,000
pediatric practice," Dr. Klass said.
to run the program in Boston
-KAREN DIEGMUELLER [email protected]
and its expansion.
1/96
Paging young patients
GLOBE STAFF PHOTO / JOHN TLUMAC
Dr. Perri Klass reads to Darian Walker, 5, of Dorchester at Boston City Hospital's pediatric clinic, where books are part of the prescription.
By Michael Kenney
so evaluate a child's communication skills.
CLOBE STAFF
One aspect of the program is that every child evaluat-
r. Perri Klass. who is an author as well as a
At BCH,
ed at the Well-Child Clinic gets a book to take nome. Klass
used that to hook fellow members of PEN New England -
pediatrician. said she had little trouble get-
PEN stands for poets, essayists. novelists - on supporting
ting other writers invoived in the well-es-
the project.
tablished Reach Out and Read program in
writers
"I told them that if you had a bunch of 5-year-olds
the pediatric clinic at Boston City Hospital.
clamoring for books for their birthdays or Christmas. you
In fact. they had a vested interest in it.
had a new generation of readers." she said. "If you start
Learning to read is important for children.
reach out
talking in an organization of writers about kids reading
but "it's a survival issue for writers." Klass
books. they get excited."
added. laughing.
That excitement has resulted in a number of area writ-
The program was instituted SIX years ago by chief of
pediatrics Dr. Barry Zuckerman as a way to institutiona-
with books
ers augmenting the corps of volunteers reading to children
in the clinic waiting room. and in a book fair at the pediat-
lize the well-accepted practice of using books and reading
READ. Page 38
Just what the doctor ordered: books
READ
Continued from Page 32
ric clinic.
'I told them that if you had a
Novelist Marcie Hershman of Brookline, author most
bunch of 5-year-olds
recently of "Tales of the Master Race," was among the
writers who worked the book fair. She recalled watching
clamoring for books for their
children scrambling around the display tables looking for
birthdays or Christmas, you
a particular book as "having a wonderful sense of imme-
had a new generation of
diacy."
Several youngsters asked if they could get a book for
readers. It's a survival issue
a. brother or sister, and she searched through the books
for writers.'
with the child to find one that the brother or sister would
enjoy
DR. PERRI KLASS
"What made it poignant, even empowering, was that
Author and pediatrician
you knew you were putting a book in the hands of a child
to carry home." she said. "And for the hours that I was
there, time completely evaporated."
Klass. "makes it a thing of importance. something that
Another local writer, Jill McCorkle of Wayland. au-
carries a message of importance to both the child and the
thor of "Crash Diet," a collection of short stories. said
parent."
her involvement at the book fair has inspired her to sign
"Often I'll sit and talk with the child about a book."
on as a volunteer reader at the clinic this spring, joining
said Palfrey. reaching into the wall cabinet and picking
other local authors. including novelist Sue Miller.
out the one he said was his personal favorite. Richard
Many readers: authors as well as longtime hospital
relunteers, bring their own favorite books for the chil-
Scarry's "Best Little Word Book Ever." For younger
children. there's a Sesame Street "board book" - the
uren. But if they don't, there are copies of such tradition-
THE favorites as Maurice Sendak's "Where the Wild
kind a child can safely chew on - or another personal
hings Are" and Ezra Jack Keats' "Goggles." as well as
favorite. "Goodnight. Moon."
number of books in Spanish. Portuguese and Creole.
Klass said that when she arrived at BCH six years
Dr. Sean Palfrey, a BCH pediatrician, said that when
ago she noticed that "if someone brought in crayons or
aivoungster comes into his examining room, he reaches
books to amuse the children while they were in the wait-
for a couple of things: a stethoscope and a storybook.
ing room. many of the children wanted to take them
And when the youngster's examination is over. he or
home."
the leaves the hospital with that book; some 10.000 were
And thinking as a writer, rather than as a doctor -
Even out during Well-Child Clinic visits last year. In-
Klass is the author of "Baby Doctor," the novel "Other
deed. the wall cabinet in all of the pediatric clinic's exam-
Women's Children" and a number of short stories - she
ihing) rooms contains a selection of children's books -
realized that "if we could catch these kids when they
number and coloring books for the very young. story-
came in for checkups, we had a window." "
books for the older children.
She added that the best thing about the program -
"It's a lovely thing to be able to give a kid a present
"what's really fun" - is to be able to give out books "and
the end of the visit," Palfrey said.
not just the ugly things like shots with nine needles all at
The fact that "the book comes from the doctor." said
once."
The PEN NEWSLETTER
PEN IN THE COMMUNITY
Helping Kids Learn to Chew on Books
BY JAMES VANOOSTING
IVE YEARS AGO at Boston City
F
Hospital, an educator and two
pediatricians had a great idea:
to put books into the hands of
their young patients. Very young patients,
in fact-from six-month-olds to
five-year-olds. The first thing the founders
noticed after setting up the program in
BCH's pediatric clinic was that books
started walking out with the children. But
the founders hardly viewed this as a
problem because their aim. from the
beginning, had been to place books at the
center of the children's everyday lives.
Perri Klass, a writer and pediatrician,
and a member of the Board of PEN New
England, inherited the program from
Todd Rucci of the New England Patriots reads to a patient at Boston City Hospital.
cofounder Robert Needleman. She
explains the philosophy of Reach Out and
child's terms. For a six-month-old, that
"thrilled that the first book had become a
Read very simply: "A baby should have a
may mean that the board book goes
good friend and that the boy wanted a new
book to chew on. A toddler should have a
straight into her mouth; for a toddler. it
one."
book to hold at bedtime. Books should be
may mean the fabric book becomes his toy.
Klass has inspired other members of
associated from the beginning with a
And that's okay.
PEN New England to participate in Reach
parent's caress and adult love."
Out and Read, helping create and nurture
Now, five years after its inception.
PLACES WITHOUT BOOKSTORES
young readers even before they begin
Reach Out and Read has developed into a
For many kids. a book is a unique
school. PEN members serve as readers in
three-part program. First, there's a large
possession, a rarity in their household. As
the clinic in addition to raising funds and
volunteer staff of people who read to kids
Perri Klass says, "A lot of our patients live
securing book donations.
in the waiting room of the pediatric clinic.
in neighborhoods without bookstores."
Jill McCorkle. Chair of the Reach
While waiting to see their doctor. children
With each visit to the clinic, a child will
Out and Read Committee. reports that
can sit near an adult reader, whose
see more and more books. Klass recalls
PEN New England will host a Valentine's
enthusiasm for books is infectious with
offering a book to a three-year-old child
Day Book Fair at Boston City Hospital
both young patients and their parents.
when he came in for a physical. "You gave
and, in the spring, a fund-raiser in further
Second. when doctors or nurses see the
that one to my sister," he told her. "We
support of the program. She hopes PEN
children. there are more books. as well as
already have it. I've read it a hundred
members outside her area hear about the
talk about books. Third. whenever
times." Recognizing the child's devotion
Committee's work and contemplate such a
children leave the clinic, they are given a
to the book and his cagerness for another,
program in their cities, too.
new book to take home.
Klass was happy to give him a different
James VanOosting, whose most recent
An important tenet of Reach Out and
one. She maintains that it is good for a
novel for young readers is Electing 1. J., is
Read is that books should be part and
child to understand that there are many
Visiting Professor of Communication all the
parcel of any child's experience. and on the
choices of books. She was, she says,
University of California, San Diego.
PEN NEWSIEITER
9
By Geraldine A. Collier
gram undertaken in doctors' of-
Telegram & Gazette Staff
fices that encourages parents to
A healthy
read to their children during the
The pint-sized patients of pedi-
preschool years.
atricians affiliated with The
Getting children ready to read
approach
Medical Center of Central Mass-
before they know what letters
achusetts in Worcester enjoy Dr.
mean is much like getting chil-
Seuss' words more than they do
dren ready to talk before they
the shots they receive as part of
can actually verbalize, said Dr.
to reading
their well-child visits.
Perri Klass, Boston pediatrician,
author and national co-director
Dr. Seuss and other children's
of the program.
authors are all part of "Reach
Out and Read," a literacy pro-
AT A DISADVANTAGE
Children who aren't read to
don't understand how books
work, not even the simple con-
cept that a book is read from
front to back, she said.
"By the time they get to school
they are at a disadvantage," said
Klass, who was in Worcester re-
cently to discuss "Reach Out and
Turn to PEDIATRICIANS/Next Page
PAULA FERAZZI
Dr. Perri Klass, left,
reads to Kacey
Rayder, while her
mother Debbie
Rayder, of Hopkin-
ton, looks on.
Pediatricians encouraging reading to youngsters
Continued From Previous Page
Led locally by Dr. J. Barry Han-
of primary care physicians.
Read" in workshops for health pro-
shaw. chairman of pediatrics at the
In waiting rooms, volunteers read
fessionals and educators sponsored
medical center, "Reach Out and
to youngsters. Physicians or nurse
by the medical center.
Read" encourages the involvement
practitioners also talk to parents
about what kinds of books babies
and toddlers might enjoy.
Children from 6 months to 5 years
old, said Klass, are then each given a
brand new book to take home with
them each time they come to a physi-
cian for a well child visit, usually
about 10 times by age 5. "If there are
no other books in the home, they will
at least have 10 beautiful children's
books," before they even set foot in a
classroom, Klass said.
Just the act of being read to by a
parent can be beneficial to a young
child, explained Klass, herself the
-mother of three."If you have been
held and read to, you associate read-
ing with being warm and safe and
loved
"An 18-month-old would rather be
held in your lap and given your full
attention," she said, than be plopped
in front of a video. "And, as a result,
that child will also associate books
with having fun."
The Worcester program, which
has involved the medical center
pediatricians since January, joins
efforts in Boston, Chicago, New
York, New Haven, New Orleans and
a Navaho Indian reservation in Ari-
zona.
Money to buy the books comes
from the Annie E. Casey Founda-
tion, the Worcester Telegram & Ga-
zette and the medical staff at the
medical center. An advisory com-
mittee, including Frances Jacobson.
a school-community outreach coor-
dinator, and Barbara Masley, cur-
riculum coordinator at the Worces-
'ter Arts Magnet School, recom-
mends book selections.
According to Hanshaw, the chil-
dren who have been exposed to the
program so far "have taken to it like
ducks to water."
Hanshaw said the program is now
looking for volunteers to read in
waiting rooms. Those interested can
contact Keith DuBois at the medical
center.
Central Massachusetts pediatri-
cians or family practice physicians
who are interested in joining the
'Reach Out and Read" program may.
contact Hanshaw.
Boston Globe
7/7/95
Young Readers
Weglyne Theodore of Dorchester finds a quiet reading corner at Boston City Hospital's Outpatient Pediatric Clinic-
A remedy in reading
BCH program aspires to introduce young patients to books
By Pamela M. Walsh
over a children's book," brings home to parents the impor-
SPECIAL TO THE CLOBE
tance of reading to their children, said Dr. Perri Klass. co-di-
rector of the Reach Out and Read program and a prolific au-
Children clustered around the volunteer eagerly, hanging
thor about life as a pediatrician.
on each word as she read and pointed to the pictures from
All parents want to do the best possible job of raising
the battered books on the table of Boston City Hospital's
their children, Klass said, but some don't realize how early in
Outpatient Pediatric Clinic.
life a child should be read to. Child development experts say
A few young patients just glanced at the books, before
the ideal age is 6 months.
going on to other toys. For the directors of
That is where Reach Out and Read can help; the doctor
BCH's "Reach Out and Read" program, even
gives out the first book when the baby turns 6 months old.
the glances are satisfying But their goal is more
"Most of the babies, the thing they want to do with the
ambitious: to impart to every pediatric patient a
book is chew it," Pat Cowan, the program coordinator. said.
love of reading, along with good health.
"But familiarity with books is what we are going for, so if
To accomplish it, volunteers read to patients
ch
they want to chew it, that's fine with us."
at almost every routine visit. Doctors talk to par-
The program has shown some measurable results in chil-
ents about the importance of reading to their
dren's reading habits. A survey of BCH parents published in
children and ask about the child's reading habits
the American Journal of Diseases of Children in 1991 found
at each check-up. And before the patient leaves the doctor's
that "parents who had been given a children's book during a
office, each is given a new book.
previous visit were approximately four times more likely" to
"The combination of the emphasis placed on reading by
report that their children read regularly than parents who
people with a friendly authority and with the actual handing
READING. Page 20
GLOBE STAFF WENDY MA!
at Callahan, a volunteer at Boston City Hospital's Outpatient Pediatric Clinic, reads to Martine Kenol (left), 9, and Joy Linn, 4.
Hospital encourages reading
Reach:Out and Read
information for folunteenng
donating to Reach Out and Read
READING
many of their parents, including the
ontinued from Page 17
working poor, cannot afford books.
VOLUNTEERING
Marie Mercado of Boston said,
d not been in the program.
didren waiting
Kathleen Fitzgerald Rice, the
Kids begin to
"Truthfully, I couldn't afford most of
cappointments, or at hospital
ogram's other co-director and a
associate books
these books," but her 8-year-old
with positive
daughter Elianis now has "a little li-
leased8 years
ild development specialist, said
oldacomfe with sick children.
at just having books around helps
brary of her own" from BCH.
uldren later in life Children who
feelings. Kids who
Mercado said she has seen from
eventings OF
ave limited contact with books be-
love books learn to
her own experience the difference
re beginning school, she said, tend
read.'
early exposure to books makes.
Offic
associate reading with "rote learn-
Elianis started receiving books from
g, and possibly failure."
KATHLEEN FITZGERALD
the BCH program when she was 3
(617)53451224
Through the program, "Kids be
RICE
years old, and today is an excellent
n to associate books with positive
Program co-director
DONATIONS
reader. Mercado said she goes to the
relings. Kids who love books learn
library to get her 10 books every
donations are welcome: but
read."
money is preferred so that cultural!
week. Her 13-year-old daughter,
Since the program started in
diverse and age appropriate books
Cassandra. who was not part of the
can be purchased:
989, BCH has handed out 50,000
to the books when they can see
program, reads sometimes, buy
hildren's books, Rice said, all either
themselves," Rice/said.
To Denate:
onated or bought with donated
"doesn't really like it." she said.
(617)534-5701
One reason that BCH's young
ands. The program's directors also
"Reading is the fundamental
patients desperately need the
y to hand out "culturally appropri-
thing for everything." Mercado said.
program. Rice said, is because so
GLOBE STAFF
bids
"You need to learn at a young age."
home remedies
A Book a Day
Reading is as
I come into the exam room and the two-vear-
my investigation of his heartbeat, his breath-
old starts to cry. Does he remember the 12 or
ing, his grumbly little stomach.
vital to the health
so shots he has received in a room that looks
Sometimes you go searching for your'
just like this one, given by me or some other
cause, sometimes it comes and finds you.
ostensibly friendly pediatrician? Is he recall-
A couple of years ago I inherited a job co-
and well-being
ing other experiences. like the times I've had
directing a program that integrates children's
his head pinioned down while I probed his
books into pediatric practice. Through the
of children as
ears in search of infection? Or mavbe he just
Reach Out and Read (ROR) organization,
doesn't like strangers?
based at Boston City Hospital, every child
All I know is that when I come into the
receives a book at each checkup, starting &
good food and
room he starts to cry. So I offer him the book
six months and continuing to the age of five.
in my hand. flipping it open to show a photo-
The program, which is expanding nationwide.
-egular checkups.
graph of a mother and child plaving together.
is aimed at children whose families don't
"This is for vou," I tell him, trying to sound
have the money to spend on books.
like someone who wouldn't know a hypoder-
Reach Out and Read stresses that you
BY PERRI KLASS
mic syringe if she tripped over one. "This is a
don't have to read a book word by word to a
book for vou to keep."
child, which is especially important for par-
And then as the child, somewhat hesitantly,
ents who are intimidated by reading, or for
somewhat mistrustfully, accepts the book and
immigrants who are not comfortable with
turns a page or two. I take the op-
portunity to ask his mother about
his language development-Is he
able to put words together to form
sentences?-and I take the further
opportunity to put in a plug for
reading aloud, looking at books to-
gether, playing naming games. I
explain why this can be extremely
important for her baby's future. for
his developmental progress. and,
ultimately, for his success in school.
A baby or small child can learn
early on (O link books with parental
love and attention, with the safety
of the lap. with the comfort of bed-
time. A child who has strong, posi-
tive associations with books and
stories, a child who has been read to
and likes being read to, will do bet-
ter when it's time to learn to read.
Bv the time I hook my stetho-
scope into my edrs and lift the lit-
de boy's T-shirt, he's so absorbed
in the book that he hardly notices
home remedies
Sparkling with nature's own vanilla.
English. Those of us who work with
A
romance that's heaven sent.
ROR encourage rough and familiar
use of the books.
"You know," I will say to a mother
F
watching her nine-month-old chew
appreciatively on her brand-new board
book, "babies like to look at pictures
of other babies. It's fine for her to put
the book in her mouth-that's what a
a
board book is for. When you look at it
with her. you might try naming some
of the things in the pictures." Then I
demonstrate, turning to my patient, in
a voice of exaggerated wonder. "Look
at this picture! Where's the baby's
nose? Oh, there's the baby's nose!"
If a child grows up with this pro-
gram, given all the routine checkups
B
between six months and five years.
there will be at least ten children's
O.
books at home before that child starts
kindergarten. This gives me a great
sense of satisfaction. When I think
about children growing up in homes
without books. I have the same visceral
reaction as I have when I think of chil-
dren in homes without milk or food or
st
heat: It cannot be. it must not be. It
stunts them and deprives them before
they've had a fair chance.
Homes need books. In our house,
books crowd the shelves, books stack
C.
precariously against walls, books domi-
si-
nate the tables. and books threaten to
take over the staircases. One of my
proudest moments as a mother came
in
when I yelled at my son, "Put the book
cl
down for a minute and use both hands
in
to get your shoes on!" My five-year-old
fo
daughter, Josephine, it seems, looks on
books as keys to a secret society from
which she and only she is excluded.
Her parents and older brother sit and
Tauillo
stare for hours at books with no pic-
so
tures at all, while she is still dependent
on someone else to read her a story.
When she can read. she knows, she will
be admitted as an equal to this secret
it
society. She's right.
Books represent possibility and
promise. They offer ways out of your
life and into alternate worlds, news of
other lives and other mysteries. They
offer escapism and excitement-and
72 PARENTING April 1993
Keep an eye
for children whose lives are bound by
deprivation. they offer not only es-
on the kids.
capism but also the possibility of escape.
For children growing up in poverty,
books have always offered 3 double
prize: They tell stories of a wider
world while providing the tools neces-
sary for a child to succeed in school
and later on in life. This is not roman-
tic nonsense: it is the simple reality of
the children of immigrants, the chil-
dren of sharecroppers, the children of
You're a concerned
the urban poor, who see what they can
parent.
become, and find in education and
So ask your
books the power to write their own
concerned self this
road maps. Read I Know Why the
elevator door to stop,
Caged Bird Sings. read A Tree Grows in
question: Does your
reverse and open, at
Brooklyn. read The Endless Steppe
garage door opener
most any obstruction
Think of the enormous satisfaction
meet every one
in the door's path.
of watching a smail child struggle to
of the new safety
Like a basketball.
understand the words on a page. As
standards established
A bike. Or even a
adults. long-ago conquerors of written
by federal law?
youngster.
language, few of us will make leaps
The answer is
You could say
of anything approaching this magni-
yes, if you have a new
there's a lot more to
tude. My daughter will read soon. and
Genie* Screw Drive.
her world will make a new kind of
every new Genie than
sense. She will have decoded the secret
Besides Genie's legendary
meets the eye. So enjoy your
of secrets.
reputation for years of reliable, quiet
reading and
I can only hope that my patients
performance, every new Genie
let Genie
will make the same journey. When I
includes safety features which continue
watch out for
write notes on a child's chart after a
to set the standards for our industry.
the kids.
checkup, I dutifully list each and every
Safety features like Genie's
For the
shot I've given. Then, last on my list of
Safe-T-Beam® electronic eye and our
name of a
"interventions," I write "BOOK!" I
Safe-T-Reverse* contact system.
nearby Genie-
don't love giving shots but I believe in
Together, they work like a closing
dealer, call 1-800-35-GENIE.
immunization, and when I have left a
child in tears, I can truly take comfort
in saying to myself, "Well, no measles
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the crying baby with a newly sore thigh
This original coupon with
can't appreciate it.
A comple Manuale
But when you hand over a book,
Your original sales receipt naphoto times opented:
it's something else. It's not a definite
A check ormoney or: order for and handling
assurance, not a particular promise of
(please no cash) (Make check to
Wireless Keypad-Offer
security. It's the promise of opportuni-
ty, the possibility of everything and
$49%
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allow 8 for delivery
1995: Genie of The Gente Company, Ohio
CONTEMPORAR
AUGUST 1995
PEDIATRICS
VOL. 12, NO. 8
Hemolytic uremic
syndrome
Acne update
Silent victims
of violence
Puzzler:
A 5-year-old
with cloudy
urine
Pediatrics
by the book
By Perriklass, MD, and
Steven Parker, MD
Cover story
Pediatrics by the book:
Helping children to love reading
and books in the land of TV
By Perri Klass, MD, and Steven Parker, MD
Every child deserves
A
Ithough most children
reading books outside school IS a
learn to read during the
good predictor of later achievement
to become a
first years of elementary
during elementary school. 2 School
good reader-one
school. they will not necessarily go
success. in turn. widens a child's
on to read fluently or with pleasure.
range of choices for further training
who can extract
Even the achievement of functional
and job opportunities. Most impor-
pleasure, information,
literacy-the leve! of proficiency
tant. the skilled reader enjoys limit-
needed to function in the world-
less opportunities for entertain-
and entertainment
falls short of skilled reading. which
ment and edification. both as a
from the written word.
the 1985 Report of the Commission
child and as an adult.
on Reading proposes as a goal for
Pediatricians can help
children. Skilled reading is profi-
Reading as a
parents guide their
cient reading and. as a pleasurable
pediatric issue
lifetime pursuit. is an end in itself.
Pediatricians. individually and as an
school-age children
It is also a means by which other
organized advocacv group. have ex-
toward the delights
goals can be reached. A positive
panded the definition of wellness
and enduring relationship with the
and health to include many aspects
and achievements
written word can be of incalculable
of child development. family func-
that a passion
value for a child's life. The child
tion. and injury prevention. Just as
who transcends the stumbling inse-
car seats and childproof caps have
for books and
curities of early reading to find
become the province of pediatri-
reading brings.
confidence and true skill as a read-
cians, so 100 have language de-
er is well equipped to succeed in
velopment and school function.
school. Indeed. studies show that
These changes reflect success in
the amount of time children spend
conquering the old. largely infec-
tious scourges of childhood and an
awareness that a truly well child has
DR KLASS is Co-Director. Reach Out and Read
more than a healthy body. In such a
Program. Boston City Hospital: Assistant Professor
of Pediatrics. Boston University School of Medicine,
child. mental. emotional. and social
Pediatrician at Dorchester House. Boston: and the
development has kept pace with
author of five DCOKS.
age-appropriate expectations and
DR. PARKER is Director, Division of Developmental
with the ever-expanding demands
and Benavioral Pediatrics. Boston City Hospital. and
Associate Professor of Pediatrics. Boston University
of the world. especially school.
School of Medicine, Boston
In this spirit. researchers have
78
CONTEMPORARY PEDIATRICS Vol. 12. No 3
62
August 1995 CONTEMPORARY REDIATRICS
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:40
READING
eracy program developed at Boston
cerns about the child's school per-
Talking with
City Hospital, for example, pediatri-
formance and cognitive develop-
children about
cians give away picture books at
ment or because the child or parent
reading
each health supervision visit from
seems particularly interested in the
6 months to 5 years of age.
issue of reading and books. The
Pediatricians have many practi-
next level of inquiry should con-
What do you do in your free time?
cal options for promoting literacy
cern the child's home environment
Be alert for excessive TV viewing.
and skilled reading in older school-
and access to books. Ask straight-
If child doesn't specifically mention
age children as well. Because of a
forward questions such as: "Do you
reading, ask: "Do you ever read
books or magazines or comics?"
long-standing relationship with the
have a library card?" "When was
child's family, the pediatrician is re-
the last time you went to the li-
What's your favorite book?
spected for his or her medical ex-
brary?" "Do you have a bookcase
If you've never heard of it, ask what
pertise. Consequently, when the
in your room?" "Do you have a
it's about.
pediatrician promotes reading in
lamp for reading in bed?" This ap-
Do you ever read things that
the school-age child. the family re-
proach affords insight into the fam-
aren't assigned in school? What?
ceives a strong message. which is
ilv's and child's attitudes towards
If a child reads only on assignment,
linked to other important messages
books and leads naturally into
suggest that parents investigate
about the child's health and well-
specific interventions by which
some of the sure-fire books for that
being.
parents can encourage reading
age group.
In listening to the child's re-
What's the last thing you do
What the pediatrician
sponses, try to get a sense of the
before you fall asleep at night?
can do
child's competence and pleasure in
Suggest reading a book or
The assessment of a school-age
reading. The 10-year-old who
magazine.
child's relationship to the written
haunts the comic book store or col-
Do you have a bookcase in your
word provides a rough indication
lects each new volume in the
room?
of cognitive development, language
Junior Baby-Sitters Club series is a
Do you have a light by your bed
skills, and probable school func-
child who has learned to enjoy
so you can read in bed?
tion. While most pediatricians in-
reading. Encourage and appreciate
Do you ever use a computer, at
home or at school?
corporate questions about school
such behaviors, and help parents
and school performance into health
acknowledge their importance.
What do you like to do on the
computer?
supervision visits ("How's school?"
Remind parents that voracious
"What's your favorite subject?"
readers typically consume a wide
Suggest E-mail as a writing activity.
"What kind of grades do you
variety of materials: important
Suggest keeping a journal on the
computer.
get?"), we suggest asking the child
complex books, lighter reads. genre
specifically about reading. You
fiction of various kinds, newspa-
might inquire, for example:
pers. magazines, and just plain
"What's your favorite book?" "Do
junk. Children who love to read are
suggested that pediatricians play a
you read at night before you go to
children who read a lot; it is easier
key role in the promotion of literacy
sleep?" "What do you like to
to encourage the child who reads
in children during the preschool
read?" "How much time do you
comic books to try science fiction
years by providing families with in-
spend reading for fun?" The box
formation and support around is-
on the left offers some additional
The parent guide on encouraging
sues of early literacy, and by encour-
suggestions on how to get started.
reading may be photocopied and
aging parents to read to their young
You may then choose to pursue
distributed to families in your practice
children. 3,4 In the pediatric early lit-
the subject. either because of con-
without permission of the publisher.
CONTEMPORARY PEDIATRICS Vol. 12. No. 8
GUIDE FOR PARENTS
hool per-
Helping your child to love reading
develop-
or parent
ed in the
"It is a great thing to start life with a small number
oks. The
of really good books which are your very own."
uld con-
ironment
-Sir Arthur Conan Doyle, 1908
straight-
"Do you
hen was
o the li-
bookcase
1 have a
This ap-
the fam-
Read aloud to your children. Start when they're
Take children to bookstores. Even if you can't buy
towards
young. but don't stop reading aloud when they can
many new books. give children a chance to browse.
.11y into
read themselves. make it a family ritual, a special time
Bookstore browsing can be addictive and gives
y which
of day.
children ideas about the kind of books they can
ading.
borrow from the library.
Fill your home with books. Buy them new or used.
ild's re-
display them prominently, and let children read them
Encourage your children to write. Leave funny
e, of the
all over the house-at the breakfast table (or any
messages for your children and urge them to respond
casure in
meals where family conversation doesn't take
in kind. Let an older child use the computer 10 write
Id who
priority), in the living room, in the bathroom.
to a friend. Join a pen-pal exchange Give a beautiful
e or col-
journal notebook as a birthday present.
in the
Make your house comfortable for reading. Make sure
cries is a
there are good reading lights and, especially. make
Let children choose their own books. At the library
o enjoy
sure your child has a good bedside light.
or bookstore. let children pick what they want.
preciate
Everyone reads more eagerly when the choice has
Let your children see you reading. Show them. by
been his or her own.
parents
example, that reading is a valuable way to spend
ortance.
leisure time.
Limit television. The Commission on Reading suggests
racious
10 hours a week for school-age children. Watch along
: a wide
Consider a family silent-reading period. This is when
with your children. and discuss what you see.
portant
all members of the family read, separately but at the
is, genre
same time.
Subscribe to newspapers and magazines. Look for
newspa-
publications that match your child's interests. Help
st plain
Establish a bedtime reading period. Give children the
children learn their way around the newspaper.
read are
choice of going to sleep or staying up to read to
Consider subscribing to a children's magazine-
is easier
themselves.
children like getting mail. Here are some good ones:
10 reads
= fiction
Join the public library and use it. Take family trips to
Calliope (world history); Cobblestone (US history);
the library. Look for library programs, author readings,
Faces (world cultures); Odyssey (space, astronomy.
and special events that might interest children.
physical sciences). Ages 8 to 14. Each issue built
August 1995 CONTEMPORARY PEDIATRICS
GUIDE FOR PARENTS/LEARNING TO LOVE READING
around a single theme. Cobblestone Publishing,
handle it. PO Box 5481. Boulder. CO 80322-4861.
7 School St., Peterborough, NH 03458, 800-821-0115.
800-288-7898.
Cricket. Ages 9 to 14. Stories. games. poems.
Give your kids some guidance. Excellent guides for
parents include:
Ladybug Ages 2 to 6. Stories. songs. art-includes a
special section for parents.
Betsy Hearne: Choosing Books for Children: A
Spider. Ages 6 to 9. Stories. games. poems.
Commonsense Guide. New York: Delacorte. 1990.
Cricket. Ladybug. or Spider can be ordered from PO
Mary Leonhardt: Parents Who Love Reading, Kids Who
Box 593. Mt. Morris. IL 6105+-7667. 800-827-0227.
Don't New York. Crown. 1993. A teacher's passionate
argument for encouraging children to read whatever
Dolphin Log. Ages 7 to 13. Published by the
interests them. Excellent suggestions for books to
Cousteau Society. focuses on wildlife in the water.
tempt various kinds of nonreading kids
870 Greenbrier Circle. Suite =402. Chesapeake, VA
23320. 804-523-9335.
Eden R. Lipson: The New York Times Parent's Guide to
National Geographic World. Ages 8 to 1+. Science.
the Best Books for Children. New York. Times Books.
exploration of the world's natural history. PO Box
1991. Thoroughly annotated guide to books for
2118, Washington, DC 20013. 800-638-4077.
different ages-a pleasure to browse through
Owl. Ages 8 and older. Science, and great puzzles and
Parents' Choice: A Sourcebook of the Very Best Products
games. 26 Boxwood Lane, Buffalo. NY 14227-9951.
to Educate, Inform and Entertain Children of All Ages.
800-387-4379.
A consumer guide to children's books (and videos.
tapes, and computer software). Kansas City, MO.
Sesame Street. Ages 2 to 6. Familiar characters, basic
Andrews & McNeel. 1993.
skills with letters and numbers. PO Box 52000,
Boulder, CO 80321-2000, 800-BIG-BIRD.
D Taylor. D.S. Strickland: Family Storybook Reading.
Portsmouth, NH. Heinemann. 1986
Sports Illustrated for Kids. Ages 8 to 14. Stories about
professional and amateur athletes-for the child
who may not read anything else. PO Box 830607.
Jim Trelease: The New Read-Aloud Handbook. New
Birmingham, AL 35283-0607. 800- 334-2229.
York: Penguin. 1989. An infectiously enthusiastic book
about reading aloud and its place in the home. the
Zillions: Consumer Reports for Kids. Ages 8 to 14.
school, and the world. Contains excellent suggestions
Product evaluations, advice about money and how to
for read-aloud books for children of all ages.
"I cannot live without books."
-Thomas Jefferson, 1815
82
CONTEMPORARY PEDIATRICS Vol. 12, No. 8
OXYGEN
AND
INTRA-
AIRWAY
MANAGE
READING
of the colon and may Derma
a primary cause of severe
pectrum antibiotics (including
this diagnosis in patients
colits may occur during
of pseudomembranous
should include fluids.
been discontinued. or it the
membranous conts produced
super
occurs during
and those undergoing
novels than it is to persuade the
and encourage reading in children
and post the answers on an "I Love
RATION in package insert
child who thinks all entertainment
of different ages and of different
To Read" bulletin board in the
with tests using nitroprus-
requires electrical equipment to
reading abilities. To this end. you
waiting room.
(
Benedict's
read anything at all.
should stay up-to-date with the
(such as Clinisture or
In addition to including ques-
books, series, and even comics that
What parents can do
therefore it
tions about reading in the health
are currently popular with chil-
Children who love to read tend to
have been conducted to
oratory tests. In rats. repro-
supervision visit, you might con-
dren. Routinely asking children
come from homes with lots of books
dose.
mice and rats at doses up to
sider a wide range of other activi-
what they like to read will help in
in them. Jim Trelease. author of The
There are no adequate 300
always predictive of human
ties to promote reading among
this endeavor, as will familiarity
New Read-Aloud Handbook. empha-
should only be given I
your patients. The pediatric waiting
nursing temporaning
room. for example, could include a
not been established.
shell of paperback books for older
ediations
receiving the
children or a "book exchange"
shelf. where patients are invited to
(5%)
the
seen adverse reactions in
leave behind books or magazines
ai events. which were
BIU or the OD regimen
they no longer want and take home
curred in 20% of all patients.
and severe adverse reac
"new" ones in exchange. Giving
event rates included our
pain 3% nausea 7,
out a book at each visit may be
cidence of gastrointestinal
stools. in Dediatric
problematic with older children
to that seen in adult
whose tastes and interests vary
iptornatic therapy or ceasec
widely, but book lists. public li-
rhea and/or documented
hospitalization
brary information, and even
reported following the use
newsletters and children's book cat-
50 (less than 2%1 except
dominal pain dyspepsia
alogs can be made available.
umented oseudomemora-
The onset of Dseudomem-
The pediatrician should act as a
after therapy.
resource for parents. offering oral
ana. drug fever and pruri-
yndrome and serum SICK
advice and handouts on helping
children to love reading. (The
Guide for Parents on pages 81-82.
biongation in prothrombin
which includes a list of guides par-
n-ctass antibiotics
ents may wish to consult, can be
enntection, renal dystunc-
1. hernormage and
duplicated and distributed to fami-
renal impairment when
lies in your practice if you wish.)
associated with drug
Families are especially open to
with some of the excellent guide-
sizes that a love of reading is fos-
ancytopenia, neutropenia,
these suggestions when they are of-
books and bibliographies on choos-
tered by the presence of reading
in significant quantities
fered as part of a dialogue and
ing children's books. Such books
material in felicitous places: in
healthy adult volunteers
parental participation is actively
can be made available in the office
the bathroom, at the breakfast table
at the recommended
sought. To open the exchange, ask
and either lent to parents or adapted
(where even nonreaders will read
Tes-Tape IS a registered
parents such questions as, "What
into handouts and booklists. Rec-
and reread cereal boxes with apparent
do you think would work best with
ommendations from other patients
fascination), on the bed. in the car.⁵
your child?"
may also spark children's interest.
In addition to being surrounded
Rev. 2/93
In addition to offering general
Ask children (while in the wait-
by books. children who read gener-
L-31886-93
advice about books and reading in
ing room or the office) to fill in a
ally come from families where
Advantus
the home, be ready to help choose
one-sentence form: "The best
their parents and siblings read.
books that tempt, delight. reward,
book I ever read is
Pediatricians should make sure that
3439-3
August 1995 CONTEMPORARY PEDIATRICS
5
READING
their patients' parents know that
required to be present and reason-
ests. The bond of reading is further
the strongest way to send the mes-
ably well-behaved while adults talk
cemented when a parent takes the
sage that reading is important,
or during tiresome waits in line.
time to read a book the child
pleasurable. and desirable is to
enthusiastically recommends.
model what educational experts
Choosing books: Help
Parents can give children a
term "sustained silent reading."
out and stand back
wide range of reading materials.
This idea is particularly reassuring
Although parents can recommend
Children's magazines offer a child
to parents who love to read and
books. one of the distinguishing
the excitement of receiving her
who frequently, albeit guiltily
own mail and can be geared to
ask their children 10 leave
her particular interests. such
them alone-"can't you see
as sports. science. stories. or
Mom's reading a book, for
faraway places. Children as
heaven's sake? it rightly
young as 9 or 10 can be taught
(and conveniently) suggests
to find their way around
that they are not ignoring their
the newspaper. 10 locate the
children but are. in fact. en-
comics. to find one interesting
gaging in an important child-
headline every day: and 10 ful-
rearing technique.
low a front page story through
Encourage parents to insti-
to the inside. In general. the
tute a family reading period.
more parents respond 10 the
during which all members of
child's enthusiasms and cu-
the family read silently, or a
riosities, the more they can
read-aloud time in the evening,
make available books. maga-
which takes older children
zines, and newspaper articles
through an exciting book
whose content and style entice
chapter by chapter and under-
the child. Reading that IS fu-
scores the importance of sto-
eled by interest and spurred by
ries and of books. Parents may
the desire 10 know how the
also consider establishing a read-in-
joys of leisure-time reading is se-
story ends is more likely to endure
bed period just before lights-out, a
lecting the book yourself. accord-
than reading that has been dictated
set time during which children can
ing to your own interests. Most
by someone else's interests.
choose between silent reading and
children will be profoundly in-
Make sure parents know that
going to sleep.
trigued by sincere adult recommen-
writing is closely connected to read-
Finally, remind parents of the
dations. based on their own experi-
ing and should be encouraged. De-
importance of gently guiding their
ence ("When I was your age I lay
velopmentally. reading and writing
children towards reading. Parents
awake all night reading this book
represent the receptive and expres-
of children who love to read sug-
with a flashlight under the covers
sive aspects, respectively. of written
gest reading as a leisure activity
because 1 absolutely had to know
language. just as listening and
when, for example, a child is look-
how it ended"), but will recoil from
speaking represent expressive and
ing for something to do or as a
parental advice intended only to
receptive oral language. Parents
time-filler during potentially bor-
improve or educate. Parents should
who want to encourage their chil-
ing situations. ("Why not bring a
mark their children's choices in
dren's comfort with the written
book along and you can read it
reading material, not to supervise
word should help them find in-
while you're waiting?") Many chil-
or censor them. but to understand
triguing opportunities for writing,
dren are grateful for a book when
and support their tastes and inter-
by corresponding with pen-pals
CONTEMPORARY PEDIATRICS Vol 12. No. 8
READING
R
reading is not placed in direct
Take-home merrages
opposition to TV watching.
euticals. Inc. Written
Promoting something
mine bioavailability
You can promote reading by having
wonderful
992:8:1-8:5.
a "book exchange" shelf in your
In emphasizing the importance of
waiting room, providing parent
reading in children's lives. pediatri-
human dose on the
aled no evidence of
handouts, and being ready
cians act as advocates for children re-
due to CARNITOR*
d well-controiled
to suggest appropriate books
garding issues that go beyond health
e animal reproduction
for an individual child.
and safety And in contrast to warning
numan response. as
ncy only it clearly
against danger and disaster. advocacy
of books and reading offers the oppor-
hether this drug IS
any drugs are excreted
Parents should know that the
tunity to promote something wonder-
made whether :0
the drug. taking into
strongest way to send the
ful in children's lives and to argue for
to the mother.
message that reading is important,
enhancing their potential. When we
-nitine metabolism
n Proc 58:533-540.
pleasurable, and desirable is to let
help parents encourage a child to be-
their children see them reading.
come a skilled reader. we help them
Iministration.
give a gift that will nounsh a lifetimes
"
and vomiting
adverse reactions are
passion for the written word. =
incidence for these
O the confounding
reports of toxicity
REFERENCES
oral LD₅₀ of
(even by E-mail) and keeping
more than 20 hours a week. dou-
1. Anderson RC of all Becomine -4 Nation 5: Readers The
arge doses of
family journals of trips. for exam-
ble the maximum viewing time
Report of the Commission on Beading Champaich-Broana
IL. Center :or the Study of Reading. 1085
intravenously.
ple. They also might give their
suggested by The Commission on
2. Anderson SC. Wilson PT. Feeding LG Growin in read.
, given as a slow
children beautiful diaries as gifts
Reading. Parents of children who
inn and now condren spend their time outside 01 school
son. Often a loading
Reading Research Quarteriv 1988 235
metabolic crisis
and provide the opportunity to
watch TV excessively should be
3. Needlman 8. Fried L. Money 00 et at Dinic-pased :n
the following
write on the family computer.
counseled about the dangers of
tervention 10 cromote literacy Am Dis Child 1991:145:881
13h or q4h. and never
intravenous injection
4. Needlman R. Zuckerman B: Fight liliteracy Prescribe a
nmended to be in the
(Children with poor handwriting
exposure 10 violence and warned
DOOK! Contemporary Pediatrics 1992.90) ::
require. The highest
/kg.
who must struggle to produce
that TV fosters obesity, the habit
5. Trelease : The New Read-Hocc Handbook New York.
Penguin. 1989
nitine level be
readable letters have been known
of passive learning, and an aver-
6. Beenties JWJ. Van der Voon THA Television's impact
nteral therapy. Weekly
as well This
10 burst into fluency at the key-
sion to reading. in addition to cut-
on children reading skills: A review 0: research. Reading
Research Cuarteriv 1988:20.089
mistries. vital signs
a free carnitine
board!)
ting short time for other family
7. Neuman SB The displacement effect Assessing the re-
hicromoles/liter). and
activities.
lation between television viewing and reacing certermance
Reading Research Quarterly 1988.00 414
napected visually for
What about television?
Studies have demonstrated that
xior to administration.
SUGGESTED READING
mit.
Television viewing should be dis-
children who watch a great deal of
Appleyard CA Secoming I Reader Cambridge JK.
carnitine) injection
single dose ampouies
cussed during the pediatric well-
television are likely to be both dis-
Cambridge University Press. 1991
child visit, although preferably
inclined and unable to read well."
HUCK CS. Hebier S Hickman Children : Literature in The
(25°C/77°F) in carton
Elementary School. 20 5 Fort Worth, TX, -arcount Brace
scard unused portion
not in direct opposition to read-
The pediatrician should counsel
Jovanovich 1989
in no preservative.
ing, since children mav rebel
parents to limit TV viewing and en-
Lamme LL' Growing Up Reacing. Washington DC
armaceuticals. Inc.
against the idea that their TV time
courage other pursuits, including
Acropolis Books. 1985
Lipson Eden R: The New York Times Parent's Guide 10 the
xolic research
is being limited to induce them to
homework, family activities. and
Best Books for Children. New York Times Books. 1991
read. It IS useful 10 find out about
reading. This decision may not al-
Taylor D. Strickland DS. Family Storybook Reading.
how much time a child spends
ways be popular with the children.
Portsmouth NH Heinemann, 1986
each day in front of the TV. In this
but if TV time is limited to create
Weinstein T. Walberg HJ: Practical literacy Ci young adults
Educational intecedents and influences Journal Ji
country, this figure is on average
time for several other activities,
Research in Reading 1993.16.3
August 1995 CONTEMPORARY PEDIATRICS
9
Fight illiteracy:
Prescribe a book!
By Robert Needlman. MD. and Barry Zuckerman. MD
By encouraging parents to read to their children. pediatricians can get
families hooked on books at an early age. with lasting benefits to the child
A program in Boston goes one step further by giving books :0 kids ai each
well visit. from infancy until the start of school.
In recent years. illiteracy has
moved in the forefront of social
problems. National attention has
focused on the plight of illiterate
adults-some 23 million of them in
the United States-and on the
economic burden their disability
imposes. But the fact IS that illit-
eracy starts in elementary school
when children fail at reading and
writing. It is. at its root. a prob-
lem of children. About 5% to 15%
of school children have significant
reading delays. and in inner-city
schools that figure typically ex-
ceeds 25% These children are at
increased risk for failing in school
altogether. with all of the atten-
dant psychosocial morbidity: low
self-esteem. teen parenthood. de-
ing failure. because the founda-
who have a reading-disabled par-
linquency. and substance abuse.
tions of literacy are laid down long
ent. Literacy has special signifi-
Pediatricians have a special op-
before children enter school. at a
cance in these families because
portunity to prevent early read-
time when pediatricians have re-
the parents experience the per-
peated contacts with the family.
sonal cost of illiteracy every day.
OR NEEDLMAN is assistant professor 01
All parents face the challenge of
Many see literacy and school suc-
pediatrics. Bosion University School
preparing their children to read.
cess as tickets to better lives for
of Medicine
and they may benefit from advice
their children.
OR ZUCKERMAN is prolessor of
early on. Pediatric intervention
This article examines how liter-
cediatrics. Bosion University School
may be especially important for
acy takes shape in the first five
of Medicine and director division or
children at highest risk of reading
years of life. with emphasis on
behavioral and developmental bediatrics
Boston C.Iv Hospital
delay: those who live 111 poverty of
practical ways pediatricians can
FEBRUARY '992 41
LITERACY
(1) right. About haif can identify
common words in context. such as
"Stop" on a sign. "It" the name of
their favorite breakfast cereal. By
age t. many children produce lin-
ear scribbles that they call "writ-
ing" and report that these marks
"sav" something." As their knowl-
eilge of the social uses of print
grows. the: play at making notes.
lists. tiekets. bills. signs. and
cards. What they "write" they
also "read." The two skills devel-
op simultaneously
These observations have chal-
lenged the traditional notion that
chiklren learn to talk at home.
then learn to read in first and sec-
and grade. then learn to write af-
ter that. The earliest stages of lit-
eracy overlap in time with the de-
Encouraging parents to read aloud to their children IS the keystone of the
velopment of spoken language.
Reach Out and Read program Kathleen Fitzgerald Rice. MS. codirector or the
and the two remain closely tied.
program. talks with Annie Williams and her 3-year-old son. Dominique.
One of the best predictors of read-
ing ability is the size of the spoken
support its early development.
earlier exposure. it was felt.
vocabulary. Reading disability is
We will also describe our experi-
risked later learning disabilities.
increasingly being seen as an ex-
ence with a multifaceted literacy
That view began to change in 1966
pression of an underlying lan-
program in an urban pediatric
with the publication of two stud-
guage processing disorder
clinic. which is designed to help
ies showing that children who
Just as "baby talk" necessarily
parents instill a love of books in
learned to read when in preschool
precedes mature speech. so too
their very young children.
went on to excel throughout
there are immature stages of lit-
grade school. The success of
eracy the child passes through on
How literacy develops
these children was not associated
the way (1) mature reading and
The last 25 years have seen a rev-
with superior intelligence or high
writing. 11 One major difference IS
olution in the thinking about how
social class but with having been
that almost all children eventually
children acquire literacy. As re-
read to by their parents.
learn to talk. but many never
cently as the 1960s. the idea that
We now know that children in
master the written word.
literacy developed would have
literate societies begin to under-
The special role
been considered ridiculous by
stand about reading and writing
of reading aloud
most educators. Reading and
at a very early age. For example.
writing. it was widely believed.
most 3-year-olds know how to
The factors that influence the ac-
could be taught only by experts,
hold a book (even if they hold it
quisition of literacy are numerous
and only after the child had
upside down!). and can follow the
and controversial." but there is
reached a mental age at 6½." Any
print from top to bottom and left
surprising unanimity about one of
42 CONTEMPORARY REDIATRICS
Talking with parents about books
Having cooks in the examination room ailows the
a healthy drive or independence re S not being
pediatric ar to model book sharing directly and 10
bad.
comment on the child S response to the book.
Here are some suggestions for brief anticipatory
18 to 36 months
guidance combining information about the child S
" your toacter istens 10 a story for live minutes.
emerging Meracy with other developmental and
that a ong time Sicries are a good way 10 nelo
behavioral issues
toddlers ncrease their attention scan
Sometimes it 3 better not :C read what $ actually
6 to 12 months
written in the book. You can just talk about the
Comment while baby IS looking at Dictures:
pictures instead.
She really looking. moving ner arms with
Your toddler will want 10 pick the cook. the time.
excitement and talking. Even infants love
and the person 10 do the reading Let your toacler
picture cooks
make choices within the limits of what $ OK
You can make story time part of your baby S
Children learn by imitating. Does she ever
routine. before Ded or naps.
Tread to ner teddy bears or dolls?
You teaching your baby that books leel
good
3 years and up
Bacies love rhymes and songs
One way children learn to read :S DV hearing the
same story over and over It might be boring 10 /CU
12 to 18 months
but Il isn to her
When you ask. What that? and name ihr
Let your child finish off the ends or familiar
pictures in a DOOK. il teaches your baby that things
sentences or poems.
have names.
Your child might want :0 tell you a story. and it
Once babies start to walk. trying 10 hold them
may be a very different one from the one you
on your lap can De a struggle. Some babies will
thought you were reading! Each time ne reteils the
want to be up and around during a story That S
story he is practicing using language in a very
OK
important way.
Oller stories each day but !el your child be in
Play writing is the hrs: step toward learning now
charge or now long you read.
to spell Does she ever pretend :0 write or ask vou
When your child grabs the book he is showing
10 show her ner name?
these-reading aloud by parents.
quired for eventual success III
have an emotional tie to books.
The early stages of literacy unfold
reading. Why are books such
founded in their earliest relation-
without formal instruction. but
powerful promoters of literacy?
ships. Favorite books may join
that is not to imply that children
Perhaps most important. posi-
teddy bears and blankets as tran-
acquire literacy "by osmosis. Pa-
tive exposure to children's books
sitional objects. easing the sepa-
rental input is critical. The 1985
motivates children to master
ration at bedtime. Children also
National Commission on Reading
reading for themselves. Children
use stories to satisfy desires vi-
cited reading aloud by parents as
who are read to from a young age
cariously and to work through
"the single most important activi-
learn to associate books with their
their fears and problems. 1: They
ty for building the knowledge re-
parents' love and attention. They
see reading as a way to obtain
FEBRUARY 1992 43
LITERACY
Developmental milestones of early literacy
Motor
Cognitive/social
Interaction
6-12 mo
Reaches for book book :0
Locks at Dictures. vocalizes.
Parent noids child comfortably
mouth: sits in iap. head 00
pats Dicture prefers chotos of
face-to-lace gaze. follows baby $
steadv
laces
cues for more and stop
12-18 mo
Holds book with help. turns
No longer mouths right away:
Child gets upset if parent won give
pages. several at a time. sits
points at pictures with one finger:
control of book. may bring COOK to be
without support: may carry
may make same sound ior a
read: if parent insists that the child
book
particular bicture (labels)
listen. child may insistently reluse
18-36 mo
Turns one page at a time:
Names familiar pictures.
Parent asks "What's that?" and
carries book around house
attention nighly variable.
gives child time to answer: relates
demands story over and over
book 10 child's experiences. :S
reads bocks :0 dolls
comfortacle with fluctuating attention
or toddler
3 yr and up
Holds book without help
Describes simple actions: can
Parent asks What's happening
turns normal thickness pages
retell familiar story: plays at
questions: validates child's
one at a time
reading. moving finger from left
responses. elaborates on them:
:0 right. top to bottom. "writes"
does not arill child but snows
name (linear scribble)
pleasure when child supplies word
pleasure. information. and solace.
with the belief that reading is im-
torture. Newer educational ap-
This positive relationship with
portant and fun. But that assump-
proaches that emphasize the use-
books becomes critical when chil-
tion may not be valid for children
fulness and pleasure of reading
dren go to school.
who have not been read to regu-
may help children and adolescents
Traditionally, elementary read-
larly. When reading is presented
who have failed with the tradi-
ing instruction has focused on de-
as a set of cognitive tasks that are
tional method. 11
coding and phonetics-the how of
unconnected to the child's basic
In addition to motivation, books
reading-with little attention to
interests. children who are not al-
also play an important role in the
its meaning and enjoyment-the
ready strongly motivated to read
development of verbal language.
why. 13-11 The assumption seems
may come to see it as an empty
which in turn is highly correlated
to be that children arrive at school
exercise or. worse. a form of slow
with literacy. When parents share
44 CONTEMPORARY PEDIATRICS
CHRISTINE SALAC DUBOV
A
POCKE
Age
Suggested books
Comments
24 mo
Here -re VA -enas
Books can he's with counting.
Ten Nine Eight
naming CCCV carts The ast
The Runaway EU
we istec emonasize
ndedencence. beichging anc
Cadcy and
family relationships
COR
36 mo
Whisge or
Noistle or Name 37 Edra Jack
Big Friend Little Friend*
Keats and the -aroid COOKS CV
Secr LOCKS If Docositest
Crockell canson are classics
that parents remember
marcic and ne Purcle
from their DWC chicked
Cravent
LowN
18 mo
The Snowv Davi
The Enown Day S another
Idalia $ Project 480
Edra Jack Keals classic
Messv Bessie
perfection winter calle
Project S an urcan alchace in
EZRAJACK KEAL
Josnua James Trucks
English and Scanish Bessie
Harcic's ABCs
$ 3 special lavorite of we
wno Date : C.C.K CC
THE
50 mo
Sometimes Trings Change
The Children : Press Econs
1 Codic Still Se a Bird
are all available n Scanish
Some CI the Days 31
translations Nontiction ..ke the
SNOW
Evereit Anderson
if Still Could 3e series helds
children inderstand their
- Chair 'cr v/v Mother:
were Everell Anderson S
Cordurov³
DAY
coerry SCOUL the CIIV
72 mo
Listen C we
Need Clay Buigs crose-
when Clay Singsi
ocerry BCCU Native American
Music Music or Evenione
culture The original Surporey
: Could Still Be 11 Free
COOKS are genue aver es
Corcurov
TEN.
Publishers: For crices and ordering. call the cuclisher request special sales. and
jSK GCOUP their cremium discount 10% io 60% decending in clume!
NINE
Checkerboard Press Facine NI 1-414-609-8182 Firerily Books. CIC Chiario
Canada 1-416-499-8412 Rancom House, nc., Westminster VIC 800-638-6460
"Harcer Collins New 207-7000. Publishing Co East Furn.
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encrd. II 201-933-9292 King Penguin New 2.689.7408 Vil.
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York NY -212-702-2000 Writers and Readers Professing
Molly Bang
112-982-0158
20
Sall
cren
S
Press
Chicago
LITERACY
school are typically criticized or
told to "get to the point. The in-
Literacy groups that can help
troduction of written stories at an
early age can help in bridge this
Reading Is Fundamental (RIF) is a national organization with
gap between home and school.
local chapters across the country (1-202-287-3220) RIF groups
The goal is not In replace the lan-
raise money 10 Ouy cocks for children and might provide
guage of the home but (1) help chil-
expertise. energy and COOKS
dren become adept at switching
between school and home cul-
The International Reading Association (IRA), through its
tures. SD they can succeed in buth.
state and local councils donates children S DOOKS io such places
as hospital wards. prison waiting areas. and adolescent
Clinical implications:
psychiatric facilities. To find the council in your area. call the IRA
What pediatricians can do
main office in Newark DE at 302-731-1600
The critical role of reading aloud
Another resource .S the National Literacy Hotline. a
in the development of literacy
clearinghouse for literacy groups (1-800-228-8813)
suggests a simple pediatric inter-
vention: encourage parents to
read to their children. The fact
that literacy begins to take shape
during the first two years of life
books with their young children.
Exposure to stories also teach-
comes as a surprise to many par-
they engage in repetitive verbal
es children how literary narra-
ents. Some are motivated to begin
exchanges or "routines." In a
tives are constructed. with a be-
reading aloud, while others are
typical routine. the parent draws
ginning. middle. and end. The un-
pleased to receive reinforcement
the child's attention to a picture
derstanding that stories unfold in
for something they already do.
by pointing and saying something
a particular sequence is important
Even parents who read aloud reg-
like. "Look! What's that?" The
for school success. such as during
ularly may benefit from guidance
child responds with a word. or
"circle time" when children are
about how best to do it. in a ran-
perhaps just a sound. The parent
asked to describe what they did
domized trial. when middle-class
then supplies the correct word.
over the weekend. or later when
parents were trained to ask open-
with some praise for the child's et-
they are required to produce co-
ended questions. give feedback.
fort: "Right! It's a dog!" The you-
herent essays. Children who are
and request elaborations. their
tine then repeats with another
read to can internalize this narra-
children showed marked and sus-
picture. Over time the routine be-
tive structure at an early age.
tained advances in spoken lan-
comes more complex. with the
Bv contrast. many children in
guage. although the frequency of
parent requesting not only labels
minority cultures are exposed to
book sharing was unchanged. 1.
but also descriptions of objects
oral storytelling, which follows
In addition to suggesting the
and actions. 15 The elements of
different conventions and rules of
use of books. the pediatrician can
shared attention to an unchanging
organization. The old notion that
help parents recognize their chil-
stimulus. immediate feedback.
these children are "linguistically
dren's literate behavior for what
and the parent's ability to adjust
deprived" is not supported. The
it is. The fact that parents inter-
the difficulty of the task to the
language of oral stories is often
pret their infant's cooing and bab-
child's growing competence make
complex. intriguing, meaningful.
bling as "talking" and respond as
such book routines ideal for learn-
and poetic. But children who try
though the sounds were meaning-
ing language. 16
to use this adium in elementary
ful may be critical in the develop-
50
CONTEMPORARY PEDIATRICS
LITERA
ment of speech. Similarly, if par-
ing program at Boston City Hos-
dren's book. a present from
ents come (1) see their toddler's
pital represents one approach to
elinic. Having books 111 the exa.
horizontal scribbles as "writing."
this dilemma. The Pediatric Pri-
nation room allows the pedia
however immature. they can re-
mary Care Center at Boston City
cian to model book sharing dire
spond in a way that nurtures the
Hospital serves a culturally and
IV and to comment on the chil
child's written self-expression.
ethnically diverse population.
response to the book (see "T.
The pediatrician can also ex-
with a high proportion of single-
ing with parents about books
plain that. as with other devel-
parent families and families living
page 43). The child is given a b.
opmental processes. children ac-
in poverty. Many children show
at every visit, 50 that by as
quire literacy by making mis-
early speech and language delays
he or she has a library of it'
takes. by trying one approach.
and have difficulty learning (1)
12 books from the doctor. In the
then changing it. then changing it
read. For the last three years.
years. the ROAR program
again. Each child has to "invent"
pediatricians and early childhood
distributed over 12.000 boo
reading and writing for him 01'
educators at the hospital have
The average cost is $2 per b.
herself. 19 This reasoning may dis-
been working together to incorpo-
or coughly $24 per child for at
suade some parents from being
rate support for literacy develop-
"course." The money has (:
overly didactic in an attempt to
ment into pediatric primary care.
from charitable foundations. i:
make their children "smarter."
We call the program Reach Out
vidual donors. and hospital fun
Busy parents need to understand
And Read. or ROAR. It has three
The fact that the doctor
that the child's motivation to read
components: modeling. guidance.
sents the parent with an item
derives largely from positive as-
and books.
obvious monetary value com
sociations between books and the
The program begins in the
the importance of reading alou
parent's attention. Mechanical
waiting room. where volunteers
is way that words cannot.
stimulation. be it stories on tape.
look di picture books with chil-
mother explained. "Every or
"talking" toys. or educational
dren, modeling book sharing tech-
went to the doctor. he kept gl:
television. is no substitute for a
niques for the parents. It contin-
me these books. I figured he m
warm lap.
ues in the examination rooms
want me to do something
where. at every health supervi-
them! He must want me to rec
The Boston program:
sion visit from 6 months on. the
Reach Out and Read
my child!"
pediatrician provides anticipatory
Children's books are forenz
Encouraging parents to share
guidance about literacy. Talking
many immigrant and minority
books with their children can be a
about literacy at each visit rem-
tures. 50 we distribute books
simple but powerful intervention.
forces the message that books are
portray those cultures and
For the families at highest risk.
important and allows the pediatri-
sent book sharing as one Wa
however. merely talking about
crans to match their advice to the
nurturing literacy. but not
the importance of books is unlike-
child's developmental level. Twice
only one. Because many par
Iv to change parental behavior.
a year, preclinic conferences are
have low literacy skils th
When money is scarce and the
devoted to a discussion of effec-
selves. we stock books that 1.
stresses of daily life are over-
tive and efficient ways of talking
few or no words and talk ai
whelming. children's books and
with parents about literacy. One
"sharing" books. not "read
the time to share them may not be
technique, for example. is to "pre-
them. We stress the import.
a priority. Parents who find read-
scribe" story time for five minutes
of eliciting the child's respo:
ing frustrating or impossible have
every day.
and making book sharing a
difficulty communicating a love of
During the visit, the pediatri-
and loving experience.
books to their children! The read-
cian also gives the parent a chil-
In the course of discussing
FEBRUARY '99.
LITERACY
child's relationship :0 books. it is
parent's pride and relief: "He
care. hut also III the lead screen-
often possible to ask parents how
really likes it. and he's SO young!"
ing. infectious disease (HIV). and
they felt about books as a child.
In this way. we make common
failure-to-thrive elimes.
whether they were read to by
cause with parents on a lev that
To evaluate the impact of the
their parents. and how they feel
has meaning for them. and give
literacy program systematically.
about reading now. In this con-
them the message that their ac-
we conducted a case-control study
text. parents may admit that they
tions now can have il beneficial et-
in which we interviewed parents
dislike reading or "never learned
fect on their child's future.
about "things they did with their
to read." This may represent the
Second. books can provide a
children." When asked to name
disclosure of a closely guarded se-
framework for positive interac-
the child's three favorite activi-
cret. A nonjudgmental response.
tions with young children. Inex-
ties. parents who had been given
recognizing the parent's desire for
perienced parents may not know
a book by théir pediatrician were
something better for her child. is
how to play with young children.
four times more likely to mention
helpful. We follow up with a refer-
Opportunities for play may be
books than were those who had
ral to an adult literacy program.
limited for families in poverty. be-
not received books. Parents re-
Families whose primary lan-
cause of lack of resources or fear
ceiving Aid to Families with De-
guage is not English pose il special
of street violence. Book sharing
pendent Children were nearly
chailenge. Except for Spanish.
requires physical closeness. pro-
eight times more likely to do so.
books for young children in other
vides a mutual focus of attention.
Parents who received guidance on
languages are hard to find. expen-
and encourages a pattern of give-
literacy alone. without books
sive. or simply nonexistent. Par-
and-take interaction. As one
themselves. showed no increase
ents may be eager to teach their
mother said. "Looking at books is
in reported book use. We conclud-
children English but may not be
something we can do together."
ed that. in a high-risk population.
fluent themselves. By talking
Third. observing the child's be-
physician involvement plus books
about the pictures in books. using
havior with a book can provide im-
may be needed to increase chil-
their native language. parents
portant information about atten-
dren's exposure to literacy.
provide a model of grammatically
tiveness, fine motor abilities. and
High-risk populations
correct language. With this as a
language (See page 44). Watching
foundation. children can readily
how the child and parent negoti-
Talking with parents about litera-
pick up English later from their
ate control of the book can offer
cy development IS a simple and
English-speaking peers.
clues to their relationship: Can
powerful intervention. To be et-
the parent allow the child free ex-
fective with families most at risk.
How effective is it?
ploration of the new object. or is
however. we need to include fur-
We have learned several lessons
the parent rigidly didactic and pu-
ther interventions. such as model-
from our clinical experience with
nitive? How does the child i'e-
ing by volunteers and distribution
books. First. the parents who
spond to the parent's attempts to
of books. This is where collabora-
come to our primary-care center
direct exploration?
tion with educators and communi-
are intensely concerned about
Giving a book takes almost no
ty groups can pay off.
their children's ability to "make
time. The effects on the doctor-
Every community has organiza-
it" in school. We learn of these
parent relationship. though hard
tions that are committed to pro-
feelings after we hand their 6-
to measure. can be palpable. One
moting literacy. Recognition of
month-old a board book and ad-
sign of this effect might be the
the need to provide literacy ser-
mire the way in which the baby iu-
level of acceptance of books by pe-
vices to parents and children at
cuses on the pictures. reaches.
diatricians in the clinic. Books are
the same time has leil to the de-
and vocalizes. Then we watch the
now used not only in primary
velopment of family or intergen-
54 CONTEMPORARY PEDIATRICS
LITERACY
erational literacy programs. 21
Collaboration can also make it
go to a bookstore with your educa-
Such organizations might wel-
easier to raise funds. Potential
tional collaborator 01 other expert
come an invitation to set up shop
funding sources include charitable
on children's literature. Find
in a pediatric waiting room. That.
foundations. private donors. and
some books you like. then buy
after all. is where the children
churches. As more business lead-
them in bulk from the publisher.
are! ROAR receives volunteer re-
ers realize the economic impor-
Most publishers give substantial
cruitment and coordination. plus a
tance of a literate work force.
discounts (40% to 60%) in charita-
part-time "paid volunteer." from
more are supporting literacy ini-
ble organizations that purchase
two community agencies. A third
tiatives. What image-conscious
100 copies or more. Some of our
organization has initiated a series
business could resist the chance to
favorite titles are listed in the
of waiting room workshops for
support both literacy and chil-
"prescribing guide" on page 46.
parents. Individuals with exper-
dren's health? Newspapers and
To locate an educational collab-
tise in early childhood education
bookstores are also natural allies.
orator. start with a nearby gradu-
can be valuable collaborators:
Two bookstores regularly contrib-
ate school of education. if avail-
three have been instrumental in
ute books to ROAR.
able. or with local schools and
creating ROAR and training vol-
Once the funds are in hand.
libraries. Ask about volunteer or-
unteers and pediatricians.
buying the books is simple. Just
ganizations that provide tutoring
LITERACY
for school children. For additional
older children and parents. For
information. contact national 01-
children at risk because of pover-
ganizations that promote reading
ty or parental reading disability.
in children (See page 50).
we can go further. providing mod-
els of effective book sharing and
Summary
actually giving out books. These
Pediatricians have a special op-
services can be secured by identi-
portunity to help parents nurture
fying and collaborating with com-
the development of literacy in
munity literacy groups.
young children. We can talk with
In reaching out to parents. we
parents about the importance of
align ourselves with their aspira-
preschool literacy and emphasize
tions for their children's future.
the power of picture books to
As one parent told us. "I know
stimulate both written and spo-
that by keeping her nose in books.
ken language. We can keep our
she's going to be a reader. If she's
waiting rooms stocked with high-
a reader she could be a writer.
quality children's books for in-
She could be a doctor. She could
fants. in addition to magazines for
be anything!"
REFERENCES
of inneting
1. Anead it nation CI interates US Vews and world
16.
Snow
C.
IC,
3.000 MAV ii 1082
on me presence. Place
2. Levine M Bronks 2 Shonnon ; & Permine no.
17. Health SB And sectime story
pronen 10 Learning Disorders New YOU John Wiley and
skills at name incl choo Language 780
Sons 1980
11(2) 49
1. Bonck NO The shame Bosion Magazine NOV 1987
18. Whilehorst GJ Faico FL Lonigan CJ. er 1. Acceier
DO 213 311
aling language development a Dicture reac
4. Teale W Suizov E Emergeni Meracy as a perspec
on Dev Psychology 088 552
live 'or examining now young children become writers
19. Ferreiro E the interviar sciween impropation too;
and readers as Teale W Suizey Eleas) Emergent Liter.
assimilation " Declared areracy in Teac N Suizov E
JCV Writing and Reading Norwood NJ. Ablex Publish.
(eds) Emergent Writing and Reading Nor
ing Corp. 1986
wood NJ Anic. Publishing Card 1986
5. Morphell MV Washourn C when should children
20. Neediman " Fried L Morley D et 31 Ciinic based
benin 10 read? Elem Schi J 1931 31 196
intervention to promote Meracy. Am : Dis Child '?9'
6. Durkin 0 Chargen WIKI Read Early Can
125 881
"" Studies New for Teachers Codere Press '966
21. NICE ..... intergementional
7. Goodman Y Children coming '0 know literacy "
grains An DOCTOR .. ine Nories of
feale W Surzhv E reds) Emergent Writing and
ous Onio Center or :: reason and Training EMPLOY
Requiring Norwood NJ Anic. Punlishing Curp 1086
ment The (ivi) State ''' were 1420 CRIC
8. Favior D Family Liferacy 'ource Charten Learning
RI88062005
'O RAJU Partsmourh NH Heinemann '983
9. time W Buller M Reading and ciner learning Oilli.
SUGGESTED READING
Cullies in Buder M Hersov neds Chirdren Addiescent
1. Schickedand ,A MOM "M" - A6C,
PSYCHOLLY Modern Origin Blackwell So
stages of readers and Aushington 20
going Prinications 1985
Association or ne Education JF YOUR Children Red
10. Backerman 8 Chase C Succine rearning disanillies
informative and
and divslend A language nased mouel in Bamess L
2 Zero 10 Three Bullerin or me National Certer for
redi ADVANCES " Pediatrics Chicago rear Book Medi-
car Inlant Programs voi XII No Seor 1991, ne entire
cal Publishers. 1984
issue is devoled 10 emergent literacy and early child
11. Suizing E Children emergent reading of lavorite
hood programs)
storybooks A developmenta study Reading Research
Quarterly 1965(Summer) 458
The work on inis article was supported in Dan Ov grants
12 Anderson RC Hielien EH Scoll JA et all Becoming
from the Bureau 01 Health Care Octivery and Assistance
J Nation of Readers the Report IN the Commission on
Malerial and Chirt Health Branch (MCJ 0090941 the
Reading Washington OC. The National institute of Edu-
Bosion City HOSDITAL House Officers Association New
carion 1985
Ane Role MODICES and Friends The Old Souin Church
13. Berremeim 8 Zcian x On Learning 10 Read New
Foundation Schowishic Books Ronald McDnimid Chil
York Random House '082
Jrons Charines the Polarom Foundation The Francis a
14. Brown AL Paincipar is Purce" L Poor readers
Dewing Foundance the Braine Book Shoo and words
Teach dontinued in Neisser Uleni The ACTURNING Per.
worth Books of Cumondae The Julhors world 1:50 int:
formance of Minority Children & New Perspective Hills.
to thank Kalhieen MS coderector of
date NJ Entiaum 1985
Our And Head program .MIO Sleven Parker MO
15. Nine A Bruner J the achievement and anreccuents
viewing the induscribut
60 CONTEMPORARY PEDIATRICS
Crockett
Books at each visit:
A "prescribing" guide
To prescribe books ellectively know your COCKS as .ve" as your ramilies
Here S a selection of recommenced itles usiec CV health subervision ASK
II a child loves a cook try another from the same sublisher at the next ASK
Feel tree to move UD or acwn the ist. according = the child S interest and
parent reading level
Most of the early listings are DOOKS NICE :ew words accessione
regardless 01 language or illeracy All 01 these 00003 are alliractive surable
appropriate for a multiethnic population and allorcable ($1.50 !O $2.50
after discount). Publishers are listed celow There are many other wonderful
books. especially in the older age range CUI most are COSILV Remind
parents that libraries are a great cargain Every child should have a card'
Age
Suggested books
Comments
6 mo
Little Babies
Infants like 10 look at
ORDURO
Mv Mum
photographs 01 aces These
Quiet Little Book
are noicable chewacle board
COOKS
9 mo
My Dad
Gentle invmes encourage
Goodnight Moon
mythmic talk and noiding
Berr's Little Beatime Sion
Books help structure beatime
roulines
Toys
12 mo
Sesame Stree! Mother
Sesame Street characters are
Goose
lamiliar lavorites There is a
Shoes
arge series oi Spor COCKS with
Swor at Play
cright active ice drawings
In and Our UD and Down
15 mo
NAWA
Where S Spor?
Cardurev : CCCC wav is
Cordurov Gues :0 the
demosity the dector office
Doctor"
New walkers relate °C moving
Trucks
venicies that make noise' Busv
Spicer is nardbound with
The Very Busy Spider
BUNNY
beautiful illustrations and a
Knock! and Other Sounds
repeating formula that inviles
mastery
18 mo
Corduroy's Busy Day"
Inlants love 10 near adults make
Boats
animal sounas! / Make MUSIC
Goodnight. Own
celebrates music in strong.
simple boe!ry Books with !ew
/ Make Music'
words encourage labeling
Hello School
Margater
Wise
Brown
Pictures by Clement Hurd
TODAY
October 22, 1996
THE SUN
Section E
Doctor's orders
include reading
ct 22 1 1996
Health: Pediatricians
side down for his mother to
see.
at St. Agnes Hospital
"Oh, 'I Am A Puppy." she
prescribe books as part of
says, reading the title. "So,
you are a puppy. huh?"
babies well-being.
It's all too much for Mar-
tin, who breaks out in gig-
gles, opens the book, holds it
By SANDRA CROCKETT
over his head with two chub-
SUNSTAFF
by hands and toddles off
down the hallway as fast as
Martin McCoy stands be-
his legs will allow.
fore a bookcase just able to
Martin doesn't realize
peek over the first shelf.
he's at his doctor's office and
The 17-month-old toddler
this isn't supposed to be fun,
is usually energy in motion,
especially since he is due for
but a colorful case of books
a shot. But the book is part
has his full attention now.
of the doctor-prescribed
"You get to choose one."
treatment in the pediatrics
CHIAKI
his mom tells him. "Go
department at St. Agnes
Checkup: Volunteer Nora Lanier, a secretary at St. Agnes, a reads to Jeffrey Joynes, 3. in the
ahead, let's get one you
Hospital.
hospital's pediatrics department.
want."
The Baltimore hospital is
The sweetly round-faced
the first in Maryland to use
a national organization dedi-
ter. In fact. Michael G.
"We were 21st on the wait-
youngster considers his op-
the "Reach Out and Read"
cated to improving chil-
Burke. chairman of the St.
ing list." Burke says. "We de-
tions and then plucks a book
program. The program,
drens' lives.
Agnes pediatrics depart-
cided not to wait. We wanted
from the lowest shelf. "Lets
which is in more than 30 hos-
St. Agnes decided to
ment, was so impressed that
to do something with literacy
see what you got," says his
pitals around the country,
adopt the program in Sep-
he wasn't willing to wait for
this year."
mother. Danyel McFarlane.
receives funding from the
tember after seeing it in ac-
funding from the Casey foun-
The hospital started its
Mar in holds the book up-
Annie E. Casey Foundation,
tion at Boston Medical Cen-
dation.
*
program by [See Books. 4E)
Happy reader: Danyel McFarlane, left, and Dr. Susma Vardya enter
lain McForiane's 17-month-old Michael
Doctors prescribe
reading to children
Books,from Page 1E)
In Boston. parents who have
had contact with the "Reach Out
gathering about 1,000 children's
and Read" program are four times
books through a "gently used"
more likely to list reading as an ac-
book drive and training a cadre of
tivity that they share with their
volunteer readers.
child than parents who haven't,
The idea is to get kids and par-
Burke says.
ents into reading as early as possi-
"One of the roles of a pediatri-
ble - long before they start
clan is to give parents guidance on
school. Research shows conclu-
how to promote the health and
sively that reading to a chud. be.
well-being of their child. We are
ginning at an early age. provides
just expanding the definition of
educational and emotional bene-
the child's well-being to Include
fits. A national 1985 Commission
literacy promotion," he says.
on Reading determined that read-
McFarlane, mother of little
ing aloud is the best way to help
Martin. was already reading to her
chudren develop literacy skills
son but likes the Idea of getting
"What we are realizing is that
the reading prescription.
we get to see kids. more than any
She believes children. particu-
other professional. before they
larly when they are a little bit older
start going to school," Burke says.
than Martin. will be impressed
"Part of what we do on these visits
with the prescriptions. "I think
is to tell parents what to expect
this will definitely help the kids
We have always traditionally ad-
want to read." she says.
vised them to do things like place
But books, especially those for
covers on plugs. and on the use of
the very youngest children. are
smoke detectors."
running low "Right now, we are
How it works
looking for grants for books from
foundations." Burke says. Also,
Now* St. Agnes pediatricians
they are approaching publishers
"prescribe" reading to children
and organizations such as the As-
when they come in for their well
sociation of American Publishers
baby check-ups. Here's how the
to inquire about discount prices.
program works:
The hospital could also use more
After the parent and child sign
reading volunteers who are willing
in at the desk, they go to a cheer-
to give up one or two hours a week
ful, dark green carpeted waiting
of their time.
room. A volunteer reader sits on a
The volunteers
slightly elevated stage area and In-
vites the child (If she's old enough)
Nora Lanier. a secretary at St.
to choose a book from her large
Agnes. is one of the 20 or so volun-
wicker basket. The volunteer en-
teers in the "Reach Out and Read"
tertains the child with a story until
program. Volunteer readers are
it is time to go In the back and see
trained to be an example to par-
the nurse.
ents on how to read to their chil-
Then. on the way to the nurse,
dren, and Lanier demonstrates
the child 18 allowed to select a
stellar qualifications for the task
book from the bookcase The
She was able to earn the attention
books are grouped on each of the
- no small feat - of 3-year-old
four shelves by age group. The
Jeffrey Joynes.
child takes the book, now affixed
Lanier gets down on the floor
with a paper bookplate with his or
and makes eye contact with
her name on it. into the examining
Jeffrey. who is waiting to see his
room while she is seen by the doc-
doctor.
tor
"I've been sitting here and I am
The final stop is back at the
80000 lonely. 1 need someone to
desk where the child's parent
read a story to Which book do you
makes a future appointment date
want me to read?" Lanier shows
and is given any necessary pre-
Jeffrey her wicker basket of books.
scriptions, including a prescrip-
The child. who is in the waiting
tion to read a book every day
room with his mother Jackie,
There are different prescrip-
looks over at mom and apparently
tions for different age groups. For
is tom between sitting next to La-
instance. the "Reach Out and
nier or making a run for It.
Read" prescription for children 12
"Pick out a book," Mom coaxes
months to 18 months (complete
him.
with the hospital's logo on it) says
He chooses a book, but It is
"Name the objects on the page
tough going initially. Lanier delves
and talk about them. Let your
into the story about a confused
child hold the book and help you
bird looking for his mother. She
turn the page. Read to your child
points to pictures, pauses from
every day approximately 5 to 10
her reading to ask the child ques-
minutes.
tions. raises and lowers the pitch
The prescription for children
of her voice, and, finally. Jeffrey is
ages 5 through 7 says "Encourage
hooked Into the story.
your child to 'read' to you and tell
"Where's my mother?" Lanier
you the story. Take your child to
reads a line from the book.
get B library card and choose the
"Right there!" Jeffrey responds,
books you will read together.
pointing to a picture on the page.
When your child is ready. encour-
Another satisfied customer.
age letter and word recognition."
New or gently used children's
Burke doesn't know yet wheth-
books may be sent or taken to St
er parents will follow the prescrip-
Agnes Hospital's pediatric de.
tion, but he thinks the prognosis
partment at 900 Caton Ave., Balti-
for the program is good.
more, Md. 21229
KOR NewOrlears
SECTION
WILDREN Living
C
Monday, July 17, 1995
Literacy
prog
sets THE
shoppi
in the
doctor's
office :
for reading
By MARIGNY DUPUY
Tulane and LSU medical schools.
phere, with helpful staff, lots of chairs
Volunteer
Children's book columnist
Kellee
Aimed at parents of children ages 6
for the adults and a huge colorful quilt
M
any doctors have now replaced
Ridgeway,
months to 5 years old, the strongest
on the floor for the children. Along one
left, looks at
the traditional lollipop reward
component of the program is the
side of the quilt is a bookcase filled
a book with
for kids with no-fuss, no-muss
power of the relationship between the
with attractive books.
Jerry Dehon,
stickers, but at the pediatric clinic of
pediatrician and the
But that is not all
7, and Eric
the Medical Center of Louisiana
family. Books are not
There are also always one
Dehon, 2, at
(Charity and University hospital com-
The Medical
simply given to the chil-
There are
or two volunteers sitting
Center of
bined), doctors are trying something
dren as rewards. They
on the quilt looking at
Louislana as
new. Thanks to a new program called
are carefully selected for
always one or
books with children and
Monchel
Reach Out and Read, children leave
each child by the pri-
ready to entice a shy tod-
Johnson, 8,
the doctor's office with brand-new
mary care doctor and
two volunteers
dler with an irresistible
looks through
books.
another one
then actually "pre-
book.
The Reach Out and Read program
scribed."
ready to entice
with
For the parent with
volunteer
is a new approach to promoting liter-
When the children
two or three youngsters
Gaelen B.
acy and reading among children of
and their parents walk
a shy toddler
in tow the sight of these
Honore.
lower-income families. Co-directed by
into the pediatric clinic
at the Medical Center of
with an
diverting helpers is wel-
STAFF PHOTO BY
Susan Berry, a doctor, and Ellen
come, but there is an
KATHY ANDERSON
Beyer, a nurse, the project uses staff
Louisiana, they find a
irresistible
and pediatric residents from both the
bright, friendly atmos-
See READING, next page
book.
Continued
Reading:
tacted them," Beyer said. The
Boston literacy program was de-
Literacy
signed and developed by pediatri-
cians Robert Needleman and
program
Barry Zuckerman, and has been
running successfully at Boston
sets up shop
City Hospital since 1989.
In addition to the Tulane and
From preceding page
LSU residents, Berry and Beyer
run the local program with staff
other more subtle element. The
from several departments of the
volunteer readers are often role
Medical Center of Louisiana.
models for moms and dads who
They offer periodic training ses-
may have had little or no experi-
sions for the attending physicians
ence with books.
and residents, in which they go
over what developmental mile-
The clinic tries to arrange for
stones in early literacy the doc-
the young patients to see the
tors should be looking for and
same primary care doctor at
how to talk with patients about
every visit. The doctors check the
books.
usual things with stethoscopes,
tongue depressors and otoscopes.
Sensitivity to the parents is es-
But as a routine part of every ap-
sential. For parents who either do
pointment, they present each
not read themselves or who are
child with a new, age-appropriate
only semi-literate - or who
book and spend time talking with
speak very little English - shar-
the parent about reading.
ing books with their children can
be more daunting than simply
A child who goes to all 12 of
administering vitamins or simple
the "well" visits normally sched-
medicines.
uled between ages 6 months and
5 years will graduate from Reach
"Encouraging reading read-
Out and Read with a library of at
iness at home, long before a child
least 12 books especially chosen
goes to school, is a wonderful gift
for that child and a possible 12
for a parent to give a child. It's a
more chosen by the child or par-
giant boost toward future success
ent from the collection of attrac-
in school and in life," says Berry.
tive second-hand books in the
Berry and Beyer introduced
waiting room.
the Reach Out and Read program
Studies have shown that by the
here in March. They have used
time most disadvantaged children
funds from grants to buy books
get to school, it is too late for
at a discount directly from pub-
many of them to become good
lishers, often in quantity.
readers. Weakness in reading can
Several local schools have con-
lead to problems in school, both
ducted book drives on behalf of
academic and social, and the low
Reach Out and Read. From them
self-esteem that accompanies bad
come the second-hand books,
school performance then reduces
which are used in the waiting
the child's chances for success
later in life.
room of the clinic, after being
carefully screened by volunteers
Beyer, who is patient coordina-
to be sure that they are in good
tor for University Hospital, said
condition, are appealing to
that the local program is modeled
youngsters 5 and under, and are
after one started in Boston.
appropriate for the multicultural
"I read about the Boston
population served by the clinic.
Reach Out and Read program y in
To donate books or to volun-
the Boston Globe and then I con-
teer, call 504-588-3029
Information packets include the following:
project abstract
brochure
code card
prescription pad
current ROR newsletter
Boston Globe Op-Ed 10/27/96
"Healthy Habits" article America's Agenda Fall 1996
Catch Quarterly article Fall 1996
AAP News article July 1996
Education Week article 5/29/96
"Paging young patients" article Boston Globe 1/96
PEN Newsletter article Spring 1995
Worcester Telegram and Gazette article
Contemporary Pediatrics article August 1995
Boston Globe article 7/7/95
"A Book a Day" article Parenting April 1995
"Fight Illiteracy" article February 1992
pilot study 1991
Information from other sites:
New York Times article 12/1/96 (Connecticut Weekly)
The Baltimore Sun article 10/22/96
Philadelphia Inquirer article 9/7/96
Detroit Free Press article 5/6/96
The Times Picayne article 7/17/95 (Living Section--Rx for reading)
Reach Out and Read New Mexico information sheet
Philadelphia Inquirer - solurday 9/7/96
Children's Hospital prescribes a dose of reading
Reach Out and Read provides books to
children. They provide the enthusiasm.
By Stacey Burling
her present from the doctor. and one of
INQUIRER STAFF WRITER
the first of many books that Children's
It was after 5-year-old Sharon Caldwell's
Hospital doctors will be giving to city chil-
eye test, her ear test, the scale and the
dren,
blood-pressure cuff, and midway through
The three of them leafed through the
a page of questions designed to measure
pages together as James explained plc-
her Intellectual development that Dr.
tures, asked Sharon questions and gave
Stephanie James sprang the surprise.
McCoy pointers on how to read a book to a
She pulled a shiny new book, Wild Wild
child. Sharon's eyes brightened. She be-
Sunflower Child Anna, from Sharon's med-
gan answering James' questions more
ical chart and began showing Sharon pic-
quickly and with more enthuslasm. The
tures of a little girl in a beautiful green
Ice was broken.
place full of flowers and animals. This was
"It's not really a gift," James said as she
a different world from the West Philadel-
prepared to continue the exam. "It's part
phia homeless shelter where Sharon and
of your health care because it's going to
her eight brothers and sisters live, but
get you all buffed up for school."
Sharon and Anna had the same energy,
Thursday, Children's Hospital launched
the same dark skin, the same wide smile
a new program from Its three primary-
and big eyes.
care centers In the city. Called Reach Out
"I know you're a smart kid, and I know
and Read. the program will provide each
The Philadelphia Inquirer RON CORTES
your mom tries to read to you," the pedia-
child with a new book at every well-child
trician said as they sat Thursday in an
visit: 10 books by the time 8 youngster
Sharon Caldwell hugs a book as Dr. Stephanie James tells her that she'll be
examining room at Children's Hospital of
starts school. The centers will also have
allowed to take It home with her. That's Sharon's mother, Wanda McCoy,
Philadelphia's Primary Care Center at
used books for patients' brothers and sis-
behind the doctor. Sharon had just completed a checkup.
Cobbs Creek.
ters. Eventually, volunteers will read 10
"Oh goodness." Sharon's mother, Wanda
children as they wait for the doctor, not
ates in 13 large urban hospitals and many
the prevention trend in pediatrics. They
McCoy, chimed In. "I be reading to them
only making the walt more fun but show.
smaller neighborhood health centers.
try to keep children from being hurt by
at night. and they be wanting stories on
Ing parents how to help children get the
Proponents hope the program will pre-
teaching parents about safety. They give
top of storles."
most from a book.
vent school problems by Introducing poor
shots to ward off dangerous childhood dis-
James wrote Sharon's name on the In-
Reach Out and Read started seven years
children and their parents 10 books early.
eases. Why not also try to prevent school
side page. This would be Sharon's book,
ago at Boston City Hospital and now oper-
Doctors see It as a natural outgrowth of
See BOOKS on B3
The
RON CORTES
Dr. Stephanie James reads to Sharon Caldwell. Sharon's mother. Wanda McCoy. had brought Sharon to
the Children's Hospital of Philadelphia's Primary Care Center at Cobbs Creek.
Children's Hospital prescribes
a dose of reading for the children
BOOKS from B1
fore children learn to read. just as
sized to parents the importance of
failure with an early dose of books?
spoken language begins before a
reading. knowing full well that
Although there is some evidence
baby says Its first word.
some of them may not have a book
from the Boston program that chil-
She talks to parents about the con-
in the house. Now she knows her
dren who have been exposed to
nection between books and love.
patients will have books.
Reach Out and Read are more likely
how children come to like books be-
"I think it's just perfect." she said.
than their peers to look at books. no
cause they associate them with cud-
"I love it."
one knows yet whether it improves
dling in their parents laps. This is
Toward the end of Sharon's exam
achievement.
not about teaching your children to
yesterday. as her mother and James
But the staffers at Children's
read. she tells parents. some of
tried to figure out what shots she
thought the program made so much
whom may be a bit intimidated by
would need. the girl began fidget-
sense that they decided not to wait
books themselves. It's about teach-
ing. hopping around the room while
for hard facts.
ing them to love books.
her long. thin braids swayed around
"It's so intuitive to most parents."
The books can also be helpful to
her face. James handed her Wild
said Trude Haecker. the hospital's
the doctor. who can observe the
Wild Sunflower Child Anna. Sharon
medical director of primary care.
physical skills of children as they
stopped for a while to look at the
"We didn't feel that we needed to
reach for books or turn pages. Doc-
bright pages. allowing James and
prove the point. really."
tors can evaluate language skills as
McCoy to finish their conversation.
After months of planning. staff
children describe what they see.
Sharon took the book to her mother.
members started the program with
Books also calm children down and
"Mama. where's the bumble bee?"
financial help from the Boston pro-
make it a lot easier to talk to their
she asked.
gram and the hospital's Women's
parents.
They found a bee. and James
Committee. They expect to give
Distributing books is also some-
pointed out some daisies and black-
books to 30,000 children a year at a
thing nice that doctors can do. Too
eyed Susans.
cost of $50,000.
often. children associate pediatric
"We're going to read this to-
On Wednesday, Pern Klass, & pedi-
visits with shots and blood tests.
night." McCoy said.
atrician who is involved with the
At the Cobbs Creek center yester-
Sharon hugged the book to her
Boston program and is nationally
day. staff members spent much of
chest.
known for her books on medical
the morning reading the children's
"We can keep it?" she asked.
training. helped teach 175 center
books and reminiscing about their
"That belongs to you." James told
staffers about Reach Out and Read.
childhood favorites. They giggled at
her. "That's part of keeping you
"I've become a little messianic on
a potty-training book and spoke in
healthy."
the subject." she said as she stood in
reverent terms of another book
a hospital auditorium. She says she
about an iconoclastic young girl
feels much the same way about chil-
with a penchant for offbeat hairdos.
To Help Out
dren who go without books as she
It is that kind of love of books they
To become a volunteer
does about tt who have no food
hope to convey to their young pa-
reader or to donate DOOKS. call
or
They. too, have
"de-
t
5.
590-2001.
prived in some fundamental way."
J
was thril
by the new
Literacy. she said. begins long be-
program. She has always empha-
Reach Out And o Read
Children's Hospital
of New Mexico
In recent years, illiteracy has moved to the forefront of social
problems. More than 40 million Americans lack adequate literacy
skills. Illiteracy, at its roots, is a problem of children because
it starts in elementary school when children fail at reading and
writing. About 35% of American children have significant delays,
and in populations that are at or below poverty level this figure
is much higher.
Children are failing because their homes lack the elements to
promote language development and early reading readiness. Books
and reading aloud are the necessary vehicles to prevent early
problems in reading. This project addresses the issue of
illiteracy by providing parents with the tools and support they
need to help their children succeed in reading. Using a pediatric
clinic setting, Reach Out and Read New Mexico's goal is to give
parents of preschool children the information, encouragement, and
materials they need to make books part of their children's lives.
This project integrates literacy development into regular pediatric
care for children between the ages of 6 months and 5 years, taking
advantage of regularly scheduled well-child visits to reach parents
of young children. The program has three components:
(1)
pediatricians trained to talk with parents about the role of books
in child development; (2) distribution of free books given at every
pediatric "check-up"; and (3) availability of children's books in
the waiting rooms, a staff comprised of professionals and trained
volunteers, who demonstrate positive ways to look at books, read
to young children, and the selection of quality children's books.
The program was begun with seed money from the national Reach Out
and Read Program in March 1995. Boston University Pediatrics
Department designed the pediatric emergent literacy programs to be
initiated in health care settings nationwide. The Children's
Hospital of New Mexico, University of New Mexico Health Sciences
Center is the second site to implement this program. Julia Grimes,
MLS, Coordinator, Family Resource Library and Meloney Baty, BUS,
Coordinator, Pediatric Child Life Clinic are co-directors of the
program.
WINL. ILLEVISION
Fred Savage in "No One
THE
ould Tell," about leenage
ting violence. Page 5L
Detroit Dree Pross
onday. May 6, 1996
a book day
ALAN R free Pless
ROAR volunteer Joseph Reed reads 8 story to Michelle, in Mickey Mouse shirt, Loriess and Louis McCaskill at
Children's Hospital of Michigan.
BY CASSANDRA SPRATLING
Children's doctors
in an example of the increasing role pediatricians
hin Staff Writer
at playing in promoting the health and well-being
aking the children to the doctor is no
T
prescribe books
of children. doctors at Children's Hospital of Mic In
gin. Si. John Hospital and Medical Center and
fun for a parent. It's one of those things
other hospitals across the country are putting liter
you do because you have to. And with
to fight the disease
BC V high on the shelves of then medicine cabinets
four children, ages 1.4. 6and 8. inc lud-
ing one with asthma, Roseann
There's a direct correlation between illiter BCY
McC askill has to do it a Int.
of illiteracy
withe kinds of children whowillend upinour emer
But her last unp to the general pediatric clinic of
" ncy rooms and hospitals. "Dr. Teresa Holu said
Children's Hospital of Michigan was surprisingly
in a recent seminar that explained the ROAR pur
pleasant
"When YOU have 10 come here with more than one
gram to new doctors training 10 be pediatricians al
In the waiting area of the 1 a hospital, as baby
child intend to, it can be very herbe But look at them.
Children's
livsia snuggled and wiggled in Mc Caskill's lap. her
they ve been sitting here paying attention ever since
"What were trying 10 do is gel you to look at illit
three older children sal quietiy listening while hus
he SHI down laving someone reading 10 them and
acy as A disease that affects the child's well-being
pital volunteer Brother Joseph Reed read stories to
keeping their minds occupied - 11 5 a good idea
as he growship. The children who can't read wellare
them and other waiting child
It 5 called ROAR - Reach Out and Read - and
the ones who WP will see later with gunshot wounds
-1 was 50 happy that he came and asked if be
it's the hospital's latest prescription for preventive
could read 10 them.' says McCaskill. of Detroit
medicine
Please see ROAR. Page 4E
Doctors help
VOLUNTEER To READ
Children's Hospital of Michigan II eds vol-
unteers to read to children and financi contri-
fight illiteracy
butions to buy new books. The hosp ital pro-
vides training and asks that volunteers agree
to read for a minimum of a half-day a week,
from about 9 a.m. to noon or 1 to 4, for at least'
ROAR, from Page 1E
three months. To volunteer, call the hospital's
Volunteer Services Office and specify that you
early pregnancies and other behavior problems."
want to volunteer for Reach Out and Read. Call
Holtrop, a pediatrician on Children's mobile team,
1-313-745-5326 from 8:30 to 4:30 WE ekdays.
learned of the program from one of the men who
To contribute money for books or Indonate
developed it, nationally recognized pediatrician and
new books, call the hospital's Child and Family
children's advocate Dr. Barry Zuckerman of Boston
Life Department at 1-313-745-0064 from 8-
City Hospital.
4:30 weekdays.
Zuckerman and another pediatrician, Dr. Robert
To make a contribution, volunteer to read
Needleman, now in Cleveland, started ROAR six
or to obtain more information on the program
years ago.
at St. John Hospital and Medical Center call its
The program is based on the connection between
Volunteer Services Department at 1-3)3-343-
reading and children's well-being - and is rooted in
3680 from 8 to 7 weekdays. Drop bo tesfor
Zuckerman's philosophy that many factors contrib-
donated books are located throughout the
ute to a child's health. Illiteracy, the argument goes,
helps begin a downward spiral that very often leads to
hospital.
school failure, which correlates with substance abuse
at a young age, teen pregnancy. delinquency and
and Scarry's ABCs," "Ten, Nine, Eight" and other
other problems.
children's favorites.
So, Zuckerman and Needleman set out to develop
Holtrop. who led the session, told them the books
a program that would foster childhood literacy.
could also be a tool in their evaluations of the child's
It began almost by happenstance. They noticed
social and physical development. "When you hand
that when teachers came into their clinics anned with
him a book, is he interested? Does he grab it? How is
crayons and books to do educational assessments, the
his grasp?"
children often wanted to keep the books. It occurred
The pediatric residents received a chart outlining
to the doctors that children who learn to read well
reading-related skills children should have developed
early on tend to have better health outcomes later on.
by certain ages. Between 12 and 18 months. for
So, they reasoned, why not give them books they
example, a child should be learning to hold a book
could keep?
with help, turn pages - though it may be St veral at a
The doctors applied for grants to purchase new
time.
books, mostly for children from low-income families,
None of the doctors seemed taken aback by the
and began incorporating the promotion of Interacy
addition of this new task to their things-to-do list.
into their medical treatment.
"I agree early literacy is important, because it
The Annie E. Casey Foundation, which assists
sets the pace for your entire life," said pediatric
low-income and disadvantaged families, was SO im-
resident Dr. Crystal Morrison.
pressed with ROAR it gave Boston City Hospital a
Dr. Maha Dabbagh said it seems like a natural
grant to encourage other hospitals that wanted to
part of what doctors should be doing. "We're sup-
duplicate the program.
posed to be involved in everything relating to the
kid's development. This is a new thing. but it a good
Reading, talking, giving
thing."
Laune Dayton, an administrator at Children's in
Detroit whose job it is to help make visits there more
Real results
pleasant, heard about ROAR at a health conference.
Other hospitals' literacy programs vary slightly.
She and Holtrop joined forces, and Children's became
The one at St. John Hospital and Medica- Center
one of nine hospitals nationally to develop ROAR
in Detroit, for example, is called RX: Heading.
programs.
Donations help pay a part-time staff person read to
ROAR has three elements:
children in the medical center's waiting area, but the
Trained hospital volunteers, armed with a bag full
program also incorporates giving away new books
of children's books, read to children in the waiting
and counseling parents on the importance of eading.
room. This exposes children to good books. keeps
Separate assessments of these programs show
them entertained and shows parents some important
that children who've participated are more kely to
elements of reading to children - interacting with
be regularly engaged in reading-related activities at
them, asking them questions and encouraging discus-
home.
sions about the stories.
St. John, for example, did a telephone survey of
Pediatricians talk with parents at each well-baby
parents whose children had participated in its pro-
)
visit about the importance of sharing books with
gram. It found that the number of times parents read
children every day. Pediatricians at Children's are
to their children each week went up about 20 percent
taught that promoting literacy should be as much a
after being counseled about reading by a do tor.
J
part of their routine as talking with new parents
"The results of the study support the contention
I
about the importance of proper nutrition and immune
that a simple, inexpensive intervention by primary-
zations.
care physicians or their staff can lead to psitive
!
A free book IS given to each child at the end of each
changes that may result in increased success in
well-baby visit - the regular office visits in which a
acquiring reading skills during infancy, presche ol and
pediatrician assesses a child's general health and
the early elementary school years." said Dr. Thad
development and updates immunizations. Usually,
Jos, a pediatric allergist and co-founder if the
that amounts to 10 visits from age 6 months to 5
program at St. John, now entering its third year.
Back in the waiting area at Children's Hospital,
years.
"If a child gets a new book at the end of each visit,
where volunteer Joseph Reed was reading 1) Ro-
that's 10 new books for a child who might not
seam McCaskill's kids. his young audience had
otherwise have books in his home." said D1. Perri
grown from three to seven.
Klass, who co-directs the ROAR program in Boston.
Reed. who does his volunteer work during sum-
"That means it costs about $30 to $40 to start a
mer vacations and breaks from his job as a teacher at
home library for a child - less than the cost of one
De La Salle High School in Warren. showed the
blood test. That seems to me to be a modest
children the selection of books and allowed the 111 to
investment for a potentially tremendous payoff."
pick one for him to read.
At the recent training session at Children's
"I like to hear him read to me," said McCaskill's
Hospital, new doctors not only learned why they
8-year- daughter, Michelle.
should care about literacy, they got a refresher
After a couple of hours, Reed was about to take a
course in children's literature - an area that has
break when 3-year-old Leann Pacquette of Melvin-
1
grown considerably since they were children.
date made d plea he couldn't resist.
Twelve pediatric residents. accustomed to study-
"Read another one," she said.
t
ing high-level medical journals, sat around a table
And that's just what he did.
reviewing "Goodnight, Moon," "Corduroy," "Rich-
The Boston Globe contributed to this report.
e
7 Years
C: repeats 5 digits forward, 3 digits reverse
KEYS TO BOOK COUNSELLING
"How are a cat and mouse alike?"; "How are a penny
and nickel alike?"; knows left. right
Effective book sharing feels good. Make it fun!
math: 3+4; 6+3; 14+4 (write out vertically)
Work books into your daily routine (e.g. bedtime story)
es
L: define Polite. Brave, Roar; spell Car, Fat, Big, His,
You don't have to read the words: talking about the
read, and tell what happened:
pictures, and listening to your child are most important!
The boy has a dog.
Let your child tell you when he/she has had enough.
Not all kids love books at first - give it time.
But the boy said, "No."
Reach Out and Read
y"
The dog wanted to play on the bed.
its for
words
Then the dog went away.
P: has responsibilities at home, does homework
Reach Out and Read
8 Years
C: "How is a fish like a boat, and how are they
different?" (a dime and a nickel? a book and a video?)
"What should you do if a kid starts fighting with you?"
Reach Out and Red
dren
g
tions
math: 23+14, 29-10, 39-22 (write out vertically)
L: spell Cut, Cook, Night. Dress: read:
es),
The elephant's trunk is used like his hand.
Have you ever watched an elephant eat peanuts? He
picks up the nuts with his trunk and puts them in his
CLINTON LIBRARY PROTOCOPY
mouth. (ask, How do elephants eat peanuts?)
B: ask about favorite books; reading aloud can continue;
child and parents can alternate pages; high-interest
little
books. regular library visits important
P: limit TV and videos, especially violent ones
.)
have?"
9-10 Years
and ice
M: ask about sports (both boys and girls)
C: repeats 4 digits in reverse: 8526, 4937
gives names of week backwards; What month comes
1. stories
right before May?; point out 3 objects - child recalls
them 10 minutes later
math: 49+37, 392 +719, 283-197. 5 X 9
ince
(write vertically);
how many minutes in 1' hours?
L: spell Order, Peach, Watch, Enter; read:
we wear
The children went to the ZOO on Sunday
simple
morning. They saw many different kinds of animals.
They enjoyed the clever monkeys the most. It was
) sec.
interesting to watch them peel oranges and bananas.
words
PHOTOCOPY
They would quickly pop the fruit into their mouths
PRESERVATION
) than
(ask: Where did the children go? What did they see?
y card
What did they like most?)
B: ask child about favorite books: family reading
Printed courtesy of Durane Litho Inc. New York, NY 10011