Head Start may be too late. The iconic federal preschool program targets low-income kids between 3 and 5, but the brain forms critical language connections in its first thousand days, experts say.
That’s the message the American Academy of Pediatrics sent to doctors who care for low-income children in a recent policy statement. A child who is read aloud to and has a rich language environment enjoys distinct advantages, the report argues, which linger well into the school years.
A 2012 study, cited in the AAP report, found that 60 percent of high-income children were read to daily, while only 34 percent of those well below the poverty line were read to.
“Children from low-income homes are much less likely to have a language rich environment,” said Dr. Pamela High, director of developmental and behavioral pediatrics at Hasbro Children’s Hospital in Providence, Rhode Island. “They hear fewer words and they know fewer words at age 3 than their more advantaged peers.”
Those differences play out in vocabulary and reading ability, said High, the primary author of the APP statement.
One study, also cited by High, found that 60 percent of vocabulary differences in children between 8 and 9 could be explained by differences in exposure to language in the home before the age of 3. And 8 or 9 is when the bill comes due: 80 percent of children below the poverty line will fail to achieve reading proficiency by the end of third grade.
And while most people wouldn’t look to pediatricians as the front line of literacy, the APP notes that, for many toddlers, the family doctor is the only trusted professional who routinely sees them during those first three years.
Pediatrician intervention on early reading isn’t just an abstract idea. For over 25 years now, American doctors have been reaching out to young patients with a program called Reach Out and Read.
Combining foundation funding with local corporate sponsors and some governmental funding, ROR coordinates 5,000 primary care physicians who participate in the program.
ROR has a longstanding partnership with Scholastic Books, which gives physicians a steady supply of books. Starting at 6 months of age, kids participating in the program are handed a new book with each well child visit, High said.
The new book then becomes a prop the doctor uses to talk to the parent and the child to observe their developmental stages. The doctors observe how the child manipulates the book, how comfortable she is with it, and can point to pictures and age-appropriate questions.
Fourteen published studies prove that ROR works, said Brian Gallagher, acting executive director of Reach Out and Read. These studies include a handful of “gold standard” random controlled experiments.
At least four strong studies show that kids given the ROR treatment had more advanced vocabularies than the control groups. And other studies showed that ROR shifted parental attitudes and behavior shifted significantly.
What you do with the book varies by the child’s age, High said. “At six months, the child reaches for the book, looks at it and pats some of the pictures. As they get older they learn how to orient the book and open the pages, and name the objects in pictures.”
“Where is the baby?” “Where is the kitty?”
High looks for how comfortable kids and parents are as they look at the book together. If they are not that comfortable, she models ways to read with the child. As the child gets older, the doctor asks the child to point out letters in the child's name.
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