Promoting Early Literacy
Perri Klass
I. Description of the problem. Children who grow up without being read to and with little exposure to books and to printed language during the first 5 years of life are at a greatly increased risk for reading failure and general school failure. They are likely to reach the age of school entry with poorer language skills, poorer school readiness, and poorer motivation. Coming from print-poor environments, such children may be unskilled in handling books, lacking positive associations with books as sources of pleasure and information. Children who are not able to develop reading skills on grade level in first grade are at increased risk to continue through elementary school and even high school reading below grade level, which puts them at risk for school failure and its concomitant risks, from low self-esteem to dropping out.
II. Epidemiology. Approximately one-third of the U.S. children enter school without the requisite language preparation to learn to read on schedule. Reading difficulties in the early years of school may reflect the child’s school entry skills, as well as language issues and learning disabilities. When reading skills are tested in the fourth grade, approximately one-third of the children in the United States cannot read on grade level. Low socioeconomic status and poor parental literacy skills significantly increase children’s risk of reading problems.
III. Etiology/contributing factors. There are many reasons why children may not be read to or may grow up in print-poor environments.
Parents who were not themselves read to as children may not understand the importance of reading aloud especially to very young children.
Parents who have limited literacy skills may not be in the habit of using written language (newspapers, magazines, books, written messages) to convey or receive information.
Adults who struggled in school, or who still struggle with written language, may look on reading aloud as a difficult task, or a reminder of failure and defeat.
Families may be under significant time stress, lack resources to buy books, or live in areas where appropriate children’s books are not easily available.
Non-English-speaking parents may not have books available in their languages, may be intimidated by books in English, or may deliberately refrain from reading (or even speaking) to their children in their native language in the hope that the children will grow up speaking English.
Parents who are themselves educated may not be directly caring for their own young children, or may feel unsure about what books and reading techniques are suitable for infants and toddlers.
Families in the 21st century are faced with many competing modes of “entertaining” young children, including television, video, and electronic media.
These same electronic alternatives are available to parents and may work against “face time” with young children or “family time” centered around books.
IV. Which families need literacy promotion? Literacy promotion in pediatric primary care should be offered to all families, regardless of socioeconomic status and parents’ educational level. Special attention should be paid to families whose economic circumstances or educational background make reading aloud more challenging for parents or place their children at additional risk, to parents who have not completed high school, to parents whose English language skills are limited, to adolescent parents, and to families under extreme social and/or financial stress. Since one goal of reading aloud is to link books with pleasure in the child’s mind, literacy promotion should take place on a highly positive note, encouraging parents to help their children learn and achieve, and recommending an experience, which both parent and child are likely to enjoy.
A. History. How are your child’s language skills? Do you read aloud to your child? What books do your children enjoy? Are books a part of your daily routine with your child? Does anyone in the family have a library card? Ask children directly: What is your favorite book?
B. Identifying families at risk. It is important to try and identify parents who may be at increased risk and may need extra help because they themselves have limited literacy skills. Their children are at risk for reading difficulties and school problems, and these families may also be at additional health risk because of the parent’s limited ability to understand other written materials, including prescriptions, handouts, and pamphlets (Chapter 97). Asking about parental literacy level may feel uncomfortable and intrusive, and it may be easiest to ask for objective information (i.e., how far a parent went in school) as a routine part of patient intake; asking all parents for this information also removes the risks of making assumptions about literacy level. One study has shown that the number of children’s books in the home can be a good indicator of parental literacy level, with parents who claim less than 10 children’s books in the home are more likely to perform poorly on a test of health literacy. For families of concern, a more detailed family history, such as a parent history of learning problems or school retention, may offer important information for counseling parents and screening children.
V. Management: literacy promotion in primary care.
A. A model for effective literacy promotion. Reach Out and Read (ROR) was founded in 1989 by pediatric clinicians and early childhood educators. ROR advocates a three-component model of literacy promotion in pediatric primary care.
1. Primary care providers are trained to counsel parents about books and reading aloud at the health supervision visit.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
