Immunize your kids against illiteracy

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By Dr. Yvonne Funcke, M.D.

Kids_ReadingReading aloud with our children used to be a favorite American pastime, as beloved as baseball and apple pie. What’s happened? Reading to young children is the single most important early experience for later success (in learning to read in school), yet only 43 percent of Arizona parents report reading every day to their children. Nationally, fewer than half of young children in the United States are read to daily. And we wonder why we have fallen to 14th in reading in the World Education Ranking and our success is only rated “average” when accounting for our science ranking (17th) and our math ranking (25th). 

Literacy is a vital skill that forms the basis for academic success and upward mobility. In addition, low literacy and poor academic achievement have been correlated with poor health outcomes and numerous social and economic ills, such as teen pregnancy, increased rates of hospitalization, high school dropout, unemployment and crime. For parents and pediatricians alike, both dedicated to promoting the overall health and development of young children, this is cause for concern. 

Proficiency in reading by the end of third grade is a crucial marker in a child’s educational development. A stunning 68 percent of fourth-graders in public school were reading below proficient levels in 2011, according to a report of the Annie E. Casey Foundation. Also, a well-documented achievement gap exists in literacy performance among different racial and ethnic groups in the U.S. Recent research suggests that the difference in literacy achievement between Latino children and non-Latino white children is even greater than that between black and white children, and that gap appears as early as four years of age. Latinos are the largest and youngest minority group in our nation, and the Latino population increased 43 percent between the 2000 and 2012 Census. In Arizona, Hispanics now make up 30 percent of the state’s residents, according to the U.S. Census Bureau. 

One in five schoolchildren is Latino and one in four newborns is Latino. Never before in U.S. history has a minority ethnic group made up such a large percentage of the youngest Americans. How well public school systems respond to the Latino population surge will determine America’s economic prosperity and ability to compete globally decades from now, stressed Rep. Raul Grijalva (D-Ariz.) at a recent education conference. The future of these young Latinos is our future.

What you may not know is that pediatricians across Arizona are playing a role in the literacy of our kids, and they’re doing so without a box to check for any reimbursement. For the 800-plus signed up as Reach Out and Read Arizona (RORAZ) providers, it’s about treating the whole child – from ear aches to excellence in the classroom.

The way this 14-times peer-reviewed program works is to have pediatricians talk with parents during all well-child visits about literacy and reading to their child every day to stimulate their learning abilities. The RORAZ program, serving children from 6 months through 5 years of age, is a low-cost intervention at $60 per child over the five years of support. At each well-child visit, pediatricians give a brand new, developmentally- and language-appropriate book to the child and advice to the parent about the importance of reading aloud every day to their child. For some families, it could be the only book they have in the house. For others, it’s an important and regular reminder about an ongoing, steady diet of pictures, spoken words and written words that end up developing critical parts of the young brain.

The role pediatricians play is critical to the success of the program because of the importance parents place on guidance from their child’s physician, as well as the regular contact between parents and pediatricians during the infant, toddler and pre-school years. Years of research have informed us that parents who participated in ROR were more likely to report reading as a favorite activity, to read aloud to their children, and to have richer home literacy environments than those not exposed to the program. Furthermore, children participating in ROR show higher receptive and expressive vocabulary scores than non-ROR children. 

The program also shows benefits for at-risk Latino children, including those whose parents do not speak English. Latino children living in poverty, from households where English is not the primary language and who participate in ROR beginning at 6 months of age, have average or above average literacy skills by the end of kindergarten and good home literacy environments. Of all children participating in early literacy programs, 76 percent of them could identify a favorite book by name, demonstrating print awareness, an important skill.

So many families struggle with balancing the busy demands of work, extracurricular activities, community activities and the draw of TV and other media. Pediatricians believe, however, that the best prescription for a well-developed brain, an inquisitive mind and a successful life includes carving out time to support your child’s development by establishing reading routines in your home. Remember the very important role you play, as a parent or grandparent, in getting your child ready to learn to read and succeed. That could mean simply saying the words for things you see around you – in your house or as you drive somewhere – and then being descriptive about it. “Look up at the sky.” “The sky is blue.” “Blue is a color like red and yellow.” Look at the fluffy white clouds.” You can even spell out any of these words. 

While not all pediatricians or health care providers are ROR providers, you can find out more about the program at and let more people, including your pediatrician, know about it. There are also more tips on the site that will help you bring up your children ready to excel throughout life. RORAZ could also use your help to spread the proven, evidence-based program around the state.  

As our volunteer corps of pediatricians throughout Arizona continues to spread the “good word about reading,” we encourage all of you – parents, grandparents and community members – to play a role in infusing literacy early and often. We know it’s the best medicine for our future.

Dr. Yvonne Funcke, a Phoenix pediatrician with the Pediatrix group practice, attended medical school at Cornell Medical College and completed her residency at the University of California-San Diego. She has spent considerable time in her career working in community health centers taking care of the underserved. She is an active member with the Arizona Chapter of the Academy of Pediatrics where she serves as the Chair of the Reach Out and Read Arizona Advisory Committee and as the program’s Medical Director. Dr. Funcke was born in San Diego, California, and grew up in Baja California, Mexico. From her parent’s strong values and beliefs she learned to serve those in need and to encourage those around her to strive for the best. She is married to a pediatric cardiologist and they have two young children.

Which books to choose and what to do

smile6-12 months: Choose books with board pages, pictures and faces, bright colors, familiar objects, short in length with limited text. Hold your child comfortably with a face-to-face gaze. Follow your baby’s cues for “more” and “stop” and point and name pictures. 

Goodnight-Moon12-24 months: Choose books with board pages, familiar objects, routines (nap time, bedtime), rhyming words and new concepts (zoo animals, shapes, colors). Respond to your child’s prompting to read and let your child control the book. Remember to be comfortable with your child’s short attention span, particularly around ages 12-18 months. Ask “where’s the … ?” and let your child point, or “what’s that?” and give your child time to answer.

mama-lama24-36 months: Choose books with paper pages, rhyming words, humorous/silly books and more advanced themes (big/small, over/under). Use books according to a routine (e.g., read at bedtime) and be willing to read the same story over and over. Relate books to your child’s real-life experiences and on occasion provide crayons and paper.

eating-alphabet36-60 months: Choose books with folk tales and legends, alphabet and counting books, and books and illustrations that exercise the child’s imagination. Ask your child “what’s happening?” and let your child tell the story. And remember to encourage writing and drawing at this age.

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