A prescription for education


When I was a pediatrician in training at Boston Medical Center, I had a routine for the end of each examination. I would open a special cabinet and offer my little patient a treat. Not a sticker, not a lollipop, not a toy. A book. As the child reached out with wide eyes, I would seize the opportunity to speak with his or her parents about how much fun and important it is to read aloud.

Today, as health commissioner for Baltimore, I am asking every doctor and nurse serving low-income families to adopt a similar routine. I am issuing a "public health challenge" for all such doctors and nurses to counsel parents about how important reading aloud can be - and to give a new book to every child as part of every medical check-up between 6 months and 5 years old.

This is no gimmick. Early language skills develop from exposure to the words of parents and other adults. The more words parents use when speaking to an 8-month-old infant, the greater the size of the child's vocabulary at age 3. Children from low-income families often hear and learn fewer words. As a result, they more frequently suffer delays in their language and learning. This leaves them behind in school before they even start.

A proven way to help address this unacceptable disparity is to provide infants and young children with books and their parents with encouragement and advice on reading.

Doing so is part of a national effort called Reach Out and Read. What my professors in Boston started as a pilot over a decade ago has spread to more than 2,900 offices across the country. Kids get to choose from a diverse selection of developmentally and culturally appropriate books. Clinicians teach parents how to use books to establish regular routines at home, encourage a love of learning and foster creativity and imagination. Even those parents who are not comfortable with reading can start by telling stories based on the pictures.

Published research shows that Reach Out and Read works. Participating families are far more likely to read to their children and have more children's books in their home, and the children gain three to six months on tests of language development. All for about $5.50 per child per year.

The time is right to make this effort universal.

In Baltimore, 32 practices serving about 20,000 children participate in Reach Out and Read. We have identified about 26 practices serving low-income children that do not. The public health challenge calls for each of these practices to adopt Reach Out and Read by the end of this year. This would make Baltimore the first city in the country to adopt this effective program for all of its at-risk children.

To help reach this goal, Baltimore is receiving extra funding from the Reach Out and Read national office to hire staff to help the pediatric practices get started raising money and ordering books. We're partnering with the Maryland chapter of the American Academy of Pediatrics, which is planning to target its fundraising efforts on this initiative. And we are reaching out to foundations and corporate partners.

We're also working closely with city schools CEO Bonnie S. Copeland and the Baltimore public school system. The effort on Reach Out and Read is an important step toward implementing Baltimore's "Five Year Action Plan for Achieving School Readiness," created in 2003.

The goal is for parents across the city to read to their young children every day so that children from a very young age associate the love of their parents with a love for books and learning. We should look forward to a city full of confident young readers, bubbling with curiosity, energy and questions about the world around them.

But if they ask, the answer is, yes, doctors and nurses will still be giving shots.

Dr. Joshua M. Sharfstein is Baltimore health commissioner. His e-mail is josh.sharfstein@baltimorecity.gov.

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