Advocacy: Early Literacy: Nate Riechers Pgy1 8/16/2018

ADVOCACY: EARLY LITERACY
Nate Riechers
PGY1
8/16/2018
OUTLINE
 Patient Case
 Why early reading matters
 Reach out and Read
 How it works
 Evidence base
 Funding
 How to get involved
BR: 5 YEAR-OLD FEMALE
 Healthy, no PMHx
 Mom’s only concern: “Having trouble at kindergarten”
 Behind other kids in reading and reading comprehension
 Teacher concerned “she has hearing problem”
 Usually very social but has been more quiet at home
 Social hx
 Dad not in picture
 Mom works appx 50-60 hours per week
 Low income: on medicaid
 Daycare: plays or sits in front of TV most of day with older sister
 Reading aloud appx 2x/month
 Family hx negative
 Normal hearing screen
 Development:
 Talks in fragmented sentences with no propositions
 Cannot count to 20
 Speech only understandable about ¾ of the time
 Struggles to read page of a book
 Motor: Copies square, hops on one foot
 Social: playful and interactive with older sister in room. Potty trained
 Normal vitals and exam

“It’s okay, she will just catch up”

SCHOOL READINESS, WHY IT MATTERS
School readiness Children who enter

conveys important school with these early
advantages later on skills are more likely
 Recognize letters than their peers to
 Count to 20 experience
 Write first name later academic success
 Read words in a book attain higher levels of
education
secure employment.
SCHOOL READINESS
DIFFERENCES IN SCHOOL READINESS
 By poverty level
 Children living in poverty are significantly less likely to have any of
the “school readiness” skills
 “30 million word gap”
 By parental education
 School readiness increases as highest level of education achieved by
parent increases
 By race
 Hispanic children are less likely to demonstrate cognitive/literacy
readiness skills than white, black, or Asian
 Lowest high school graduation rate
 Parents with lower literacy
 Less likely to be read to by family members
EARLY READING MATTERS
 Children develop literacy skills and awareness of language

long before they are able to read
 Young children who are read to regularly experience boost in
literacy development
 As early as infancy
Ability to listen
Recognition of sounds and letters
Creates a positive association with books and reading
Understanding how stories work

Builds motivation, curiosity and memory
Knowledge of a wide range of vocabulary
Broadens imagination
HOW DOES UTAH COMPARE?
NCES study 2003
 It’s hard to say…..

 Appx 15% of parents
don’t regularly read to
their kids
 9 percent illiteracy rate
in Utah is better than
the national average,
which is 14.7 percent
What happens during the first
few years sets the stage for
THE
the rest of a child's life OPPORTUNIT Y
Most of a child's brain is OF A LIFETIME
formed during this critical T h e c r i t ic a l
period
period
A child's experiences
irreversibly affect how the
brain develops
Who has the most access to kids

during this critical period?
THE CRITICAL PERIOD
http://developingchild.harvard.edu/resources/inbrief-science-of-ecd/
REACH OUT AND READ
 National nonprofit
 Promotes early literacy during
well child visits
 Handing out books to kids
 Gives advice to parents about
importance of reading aloud
 Goals
 Promote children’s
developmental skills
 Promote later school success
 Promote love of reading and
books
A Reach Out and Read (ROAR)Visit
During a well check
1) Talk about importance of reading aloud
2) Demonstrate (if time)
 PEER sequence
3) Give a new developmentally appropriate book
to the child to take home and keep
 Bilingual books in 12 languages
Every well child check 6 months to
5 years
Literacy-rich waiting rooms
DOES ROAR WORK?
 High et. al., 2000

 Children in clinics participating in the ROAR program
 1) Are 2.5X more likely to be read to by their parents
 2) Have better language skills
 3) Have a greater love of reading

 Families are 2.5X more likely to enjoy reading together or have books in
the home
 4) “Dose effect”
 The more you read, the more language gains are seen
 Receptive language scores were associated with # of ROAR visits and # of
books owned
Number of days and nights per week
HIGH ET. AL., 2000
4 Intervention
Control
0
Days/week Nights/week
*Adapted from presentation by Irene Kocolas, MD

A FEW OF MY OTHER FAVORITES
Mendelsohn et al., Another study showed

Pediatrics. that Latino children
 High-risk urban families who participated in
participating in Reach Reach Out and Read
Out and Read read more from six months of age
frequently to their had average or above
children.
average literacy skills
 Children exposed to
Reach Out and Read had by the end of
higher receptive kindergarten, as well
language scores (mean: as high-quality home
94.5 vs. 84.8) and literacy environments.
expressive language
scores (mean: 84.3 vs.
81.6).
2007 UNESCO CONFUCIUS PRIZE FOR LITERACY
AWARDS
David M. Rubenstein Prize for
"groundbreaking advancement of literacy."
AWARDS
ROAR IN THE USA
 AAP: “ROAR is an essential component of pediatric primary

care”
 Cost ef fective
 $20 funds the program for one child for one year
 Widespread
 28 regional affiliates
 5,800 sites
 29,000 medical providers
 In all 50 states
IMPLEMENTATION
 Apply online to start a program at your clinic

 Secure funding
 ROAR covers most of the costs, but sometimes must find small
amount of funding
 Scholastic/other vendors often provide funding
 Online training
 Order books through their website
 Report number of ROAR -eligible visits and books given twice
per year
ROAR: FUNDING
ROAR: FUNDING
ADVOCATE FOR AWESOME PROGRAMS!
 Elected of ficials expect to hear from their constituents about

innovative and ef fective programs that are being implemented
in their home states or district
 This represents an opportunity for you to educate your
legislators about the impact of Reach Out and Read on the
children and families served in your community
 Telephone calls, letters, meetings, and Reach Out and Read
program site visits can have a tremendous impact.
11 Reasons Why Everyone Should Read ‘Harry Potter’
REFERENCES
 All school readiness data and studies from

https://www.childtrends.org/indicators/early -school-readiness
 Tierney AL, Nelson CA. Brain Development and the Role of
Experience in the Early Years. Zero to Three, 2009
 Kutner, M., Greenberg, E., Jin, Y., and Paulsen, C. (2006). The
Health Literacy of America’s Adults: Results From the 2003
National Assessment of Adult Literacy (NCES 2006 –483). U.S.
Department of Education. Washington, DC: National Center for
Education Statistics.
 Sharif et al., Journal of the National Medical Association
 Diener et al., Journal of Community Medicine and Health
Education
 High, P. C., LaGasse, L., Becker, S., Ahlgren, I. & Gardner, A.
(2000). Literacy promotion in primary care pediatrics: Can we
make a difference? Pediatrics, 105(4), 927 -934.
 Mendelsohn A, Mogliner L, Dreyer B, et al. The impact of a clinic -
based literacy intervention on language development in inner -
city preschool children. Pediatrics. 2001;107:130 –4.

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ADVOCACY: EARLY LITERACY

 Normal hearing screen

 Normal vitals and exam

“It’s okay, she will just catch up”

School readiness Children who enter

 Children develop literacy skills and awareness of language

Creates a positive association with books and reading

Understanding how stories work

NCES study 2003

 It’s hard to say…..

Who has the most access to kids

 High et. al., 2000

 2) Have better language skills

 3) Have a greater love of reading

*Adapted from presentation by Irene Kocolas, MD

Mendelsohn et al., Another study showed

 AAP: “ROAR is an essential component of pediatric primary

 Apply online to start a program at your clinic

 Elected of ficials expect to hear from their constituents about

 All school readiness data and studies from

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