Reach Out & Read: A Pediatrician’s Perspective
by Perri Klass, MD

As a practicing pediatrician, I know how busy the health supervision visit (also known as the check-up) can be. There’s a long list of topics to cover, shots to give, measurements to take, sage advice to dispense, and questions to answer. But over the past fifteen years, more and more pediatricians have added early literacy and reading aloud to that long list, routinely talking with the parents of babies, toddlers, and preschoolers about how to help their children grow up enjoying books. Fifteen years ago, at what was the Boston City Hospital, a couple of pediatricians, Barry Zuckerman, MD, and Robert Needlman, MD, together with an early childhood educator, Kathleen Fitzgerald Rice, MSEd, developed a simple strategy for literacy promotion in a pediatric clinic—the Reach Out and Read model. From that one site in that one clinic, which continues to serve a large urban population, including many children growing up in poverty and many new immigrants and refugees, Reach Out and Read has spread to include programs at more than 2000 clinics, health centers, hospitals, and private practices. I have been involved with the program for the past ten years, helping my fellow pediatricians—and family physicians and nurse practitioners—incorporate this model into their daily professional practice.

Reach Out and Read has 3 components. It starts in the waiting room (where our patients and their parents often sit for far too long) with volunteers reading aloud, with books for the children to look at, with displays about reading and literacy. Second, during the checkup, the doctor gives some age-appropriate advice about reading aloud, and third, the doctor gives the child a beautiful new book to take home—age-appropriate, culturally appropriate, and ready to be enjoyed. The program is aimed at children from six months through five years, and if we do it right—that is, if they keep all their well-child appointments and we manage to give a book at each visit—that’s ten books in the home by kindergarten age, each coming with advice and guidance.

For example, when I see a six-month-old, I offer her a board book—small for small hands, hard and chewable, and generally illustrated with pictures of faces. As she grabs it and starts to chew on it, I assess her development—can she sit along, fix and follow, reach and grab—and I talk to her parent about how normal it is for a baby this age to explore the world by chewing on things. I might model pointing and naming as I hand over the book—“This is the baby! This is the baby’s nose!”—and I make sure to emphasize that reading to children is important, even before they can talk. I try to help parents see that when a young child, eager for a parent’s undivided attention, eager for the sound of the parent’s voice, comes to associate that desirable contact with books, a positive association with books is formed which can help that child grow up enjoying books, and arrive at school with the early literacy skills she needs in order to tackle the job of learning to read.

As the children grow, the advice changes—I might reassure the mother of a two-year-old that it’s normal if he doesn’t sit still for the whole story. I might discuss books in the context of bedtime rituals and sleep issues. But the overall message is always there: this is something good—and something important—that you can do to help your child.

Many teachers have told me that they can see on the first day—or sometimes, in the first hour—of kindergarten or first grade which children have grown up with books. By putting books into more homes, by encouraging parents to start reading aloud early, Reach Out and Read hopes to make books a part of every healthy childhood. Research studies have shown us that the program increases parent reading aloud, leads to more positive attitudes towards books and reading, and improves the language scores of children from about eighteen months of age.

On a personal level, I love practicing medicine with a book in my hand. I love the children’s responses—from the six-month-old who chews on his new book right away to the preschooler who proudly describes what she sees happening on the pages. And I love watching the children go home, holding their books, taking words and pictures and the pleasures of reading aloud into their homes and into their lives.#

For more information visit www.reachoutandread.org.

Perri Klass, M.D. is a practicing pediatrician & assistant professor of pediatrics, Boston U. School of Medicine. She is the President and Medical Director of Reach Out and Read.