Rx for reading

LITTLE ROCK — Sara Sanders of North Little Rock has taken her four children to the Little Rock Pediatric Clinic for nearly eight years — in exchange for benefits that go beyond just physical health.

Through age 5, each well-child visit to the clinic comes with an added bonus — a new book.

“They look forward to their books,” Sanders said during a recent visit to the clinic with her two youngest children, 3-year-old Liam and 1-year-old Rubie. It has been nice for them to receive “something constructive and useful.”

At first, Sander says, she didn’t realize the book giveaways were part of an organized pro-literacy campaign. “I just thought we go to the doctor and we get books. Some of my other friends had told me that they got them, too.”

Then Dr. Chad Rodgers, her children’s pediatrician, explained that the book giveaways were part of a program called Reach Out and Read Arkansas, which he cofounded.

It’s in association with the Boston-based Reach Out And Read, a nonprofit organization that in pediatric exam rooms nationwide promotes early literacy and school readiness by giving new books to children and advice to parents about the importance of reading aloud. Reach Out and Read Arkansas partners with pediatricians and clinics across the state to provide age-appropriate books to patients age 6 months to 5 years during their well-child visits. It also encourages parents to read aloud to their young children each day.

Such reading “prescriptions” follow recommendations from the American Academy of Pediatrics that children be introduced to reading starting at 6 months. The national Reach Out organization, which was founded in 1989, is endorsed by the American Academy of Pediatrics.

Books the Sanders children have received include such titles as Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle; Good Night, Moon by Margaret Wise Brown; Let’s Eat!, a Scholastic book; and Shapes by Margie Palatini. They have served to reinforce a family habit. “Each one of my children has their own bookcases. We’re a family that reads,” Sanders says, adding that she reads to the children daily. “I think it’s very important.”

The Sanders children’s clinic — the Little Rock Pediatric Clinic — is one of 27 clinics participating in Reach Out and Read Arkansas, which serves more than 40,000 children from three satellite offices distributing more than 61,000 books each year. Lowincome children who may not have books at home are targeted, although the program is not restricted to them.

On average, fewer than half of young children are read to daily in the United States, according a 2009 report issued by the Department of Education’s National Center for Educational Statistics.

The report reveals that in low-income families even fewer children are read to daily — only 28 percent of 2-year-olds and 21 percent of 4-year-olds.

Arkansas, at 44 percent, ranks 43rd in daily parental reading for children age 5 or younger, according to Reading Across the Nation: A Chartbook, published in October 2007 by a collaboration of the Reach Out and Read National Center, the University of California at Los Angeles Center for Healthier Children, Families and Communities, and the Department of Pediatrics at Boston University School of Medicine).

Reach Out and Read Arkansas seeks to turn those statistics around.

READING IS FUNDAMENTAL

Peggy Sissel-Phelan, an early-childhood expert and co-founder of Reach Out and Read Arkansas, found out about the national Reach Out and Read program in 1994, when she was a researcher at Arkansas Children’s Hospital. She’d conducted interviews in the Arkansas Delta to gauge residents’ use of health insurance and how it might affect children’s grades, school attendance and general well-being. She found unexpected results: “People didn’t read well enough to [want to] open the insurance policy,” she says, adding that most of those she interviewed didn’t see the point of preventive health checkups.

As Sissel-Phelan began preparation for writing the paper outlining her findings, she researched health literature, discovered Reach Out and Read “and was absolutely fascinated,” she says. Seven years later she revisited Reach Out and Read’s website. Seeing online that there were no clinics listed in Arkansas, she called Reach Out’s Boston headquarters and found that thanks to Rodgers’ efforts the group had just approved the first potential Reach Out and Read site in the state at Arkansas Children’s Hospital.

“So I picked up the phone, got hold of [Rodgers] and said, ‘Listen, I’d love to meet with you about Reach Out and Read,’” she recalls.

For his part, Rodgers first heard about the program while attending a national conference of the American Academy of Pediatrics, which he attended during his residency at Children’s Hospital. At first, it seemed like “just a fun deal of handing out books,” he says. But then, “I had this light-bulb moment” about how many parents were surprised to find that children should be set to read early in life. Then he met Sissel-Phelan, learned about her research findings, and teamed up with her to expand the Reach Out program in Arkansas.

“It just sort of changed my life,” Rodgers says. “I didn’t think I’d be that much into childhood literacy ... but now it seems like my part-time job, of which I’m glad.”

To become an official Reach Out and Read coalition — a state office affiliated with the Reach Out and Read National Center — there had to be at least four program sites in the state. In an attempt to meet the requirement, Sissel-Phelan and Rodgers formed an organization called Our Well Child Reads.

FAR-REACHING EFFORTS

The number of sites grew slowly at first. The state’s Area Health Education Centers, which are designed to provide access to health care for people in rural areas and are also the training grounds for healthcare professionals, got on board. Meanwhile, Rodgers obtained seed money from the American Academy of Pediatrics. Forums were held throughout the state to introduce the program. The number of sites grew. And in 2008, the Arkansas group was designated as an official coalition, and Our Well Child Reads obtained the right to use the Reach Out and Read name. It also meant the effort could benefit from financial resources available through Reach Out and Read.

The cost of the program varies from clinic to clinic. In simplest terms, it can be determined by multiplying the number of children the site serves per year by $2.75, the average cost of a book, says Kathy Vining DeLone, executive director of Reach Out and Read Arkansas.

“What I do ... is try to get them started [by giving the clinic] at least 25 percent of that number,” DeLone says, explaining that each clinic comes up with the remainder of the cost.

The program works this way: A parent takes a baby to the doctor for his wellchild visit, during which he is weighed and measured, his growth and development is checked, and he receives vaccinations. “A physician will walk into the room with a book and hand the book to the baby,” Sissel-Phelan says. Based on the parent’s response, the doctor can tell right away whether the parent is reading to the baby at home. The doctor also does an assessment based on how the baby responds to the book — opening it, patting the pages, verbalizing (such as dropping the book and saying, “Uh-oh!”). The doctor notes developmental milestones of early literacy as well as the baby’s motor and cognitive skills.

The doctor then tells the parent that the child can keep the book and will be given a library of 10-12 books over the coming years. The doctor also emphasizes the importance of reading to the child.

Sometimes, even for sick-child visits, the young patient will come in asking, “Where’s my book?” Rodgers says. “That’s the thing that kind of keeps me going. This program makes my practice better and it really makes my [patients’] checkups better.”

The books are often passed on to siblings. “One exam can reverberate across a family,” Sissel-Phelan says, explaining that older siblings who tag along on well-child visits may also receive gently used, donated books.

MULTIPLE BENEFICIARIES

There are about 27 book vendors nationwide for the program, Scholastic being the leader, DeLone says. Each clinic can order books and pay for them with money she deposits into the clinic’s account.

Program-site officials are encouraged to refer a parent to an adult literacy program if it’s suspected the parent needs help with his own reading skills. In conjunction with Wal-Mart, prescription sheets encouraging the parent to read to the child are also given out. On the back of the sheets are toll-free telephone numbers for local literacy councils.

“Our research supports the claim that the intervention with the pediatrician ... will affect parental behaviors and attitudes toward reading themselves,” DeLone says.

Rodgers says he would like to see every child age 5 and younger in Arkansas participate in the program.

“I think it’s such a valuable program to getting young Arkansans off to a good start” — with the result that in, say, 20 years, the state will see a more literate, as well as healthier and happier, work force, he says.

Meanwhile, Rodgers would like to see a bigger Reach Out presence in the Delta region of the state, and DeLone says the program has several pressing needs including additional money for part-time clerical staff. And in Northwest Arkansas, there’s a need for books for children of Hispanic, Asian and Marshall Island heritage.

DeLone is optimistic that the program will gain additional funding and support as awareness of it is raised and the reality of Reach Out and Read’s motto — “Immunizing children against illiteracy” — becomes evident in the lives of those it touches. “We want to help children increase their chances of success in life.”

For more information about Reach Out and Read, call (501) 226-9444 or visit reachoutandreadarkansas.org.