Pediatric Reflections: Reading to Children

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Children's Doctor

Reading aloud to the future

Danielle C. Nicholson, DO Danielle C. Nicholson, DO Primary care pediatricians are faced with the impossible every day, incorporating all aspects of a child’s health, development, and emotional well-being into a 15-minute visit. In the age of competing screen time, few pieces of anticipatory guidance are as crucial as counseling families on the benefits of reading aloud to their children.

In a groundbreaking study, doctors Betty Hart and Todd Risley identified a dramatic gap in language exposure between low-income and high-income families. Children living in lower-income families hear roughly a third fewer words than children living in higher-income families, leading to a 30-million-word gap by age 3. Recent studies have failed to reproduce Hart and Risley’s findings, leading experts to challenge the “word gap” concept in favor of a less stigmatizing and more universal approach to early childhood literacy.

Reading to young children has a lasting impact on school readiness and is associated with higher language proficiency at school entry. It exposes them to new vocabulary, complex syntax, and emotional paradigms they may not experience in everyday life. Furthermore, the parent-child interaction around books can serve as the building blocks for a nurturing relationship that is crucial for a child’s social-emotional development.

Reading proficiency by the end of third grade is a predictor of eventual high school graduation and career success. In the 2016-2017 school year, two-thirds of Philadelphia’s fourth graders were unable to read at grade level. While the problem is magnified in disadvantaged families, according to the 2016-2017 National Survey of Children’s Health, only a little over 50% of higher income families read to their children on a daily basis. The problem transcends socioeconomic status.

In my own practice, the discussion around reading begins at the newborn visit. It goes something like: “Back to sleep, fevers are an emergency, and read to your baby!” The conversation is about to become easier. Through a partnership between Philadelphia’s Department of Health and Read by 4th, Mayor Jim Kenney recently announced a new initiative entitled “Baby Book Club.” Every infant born in Philadelphia will receive a new book before leaving the hospital.

I have yet to meet parents who do not love their children and want the absolute best for their future. Limited parental understanding of the benefits of reading aloud to children is at fault, not a lack of caring or good intentions. When pediatricians provide guidance on the benefits of reading to children, parents listen. It is our duty to educate all parents, regardless of socioeconomic status, on creating a literacy-rich environment to build cognitive, language, and social-emotional skills. This single piece of guidance may change the trajectory of a child’s life.

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