Reach Out and Read Studies

What distinguishes Reach Out and Read from other interventions is its large and growing evidence base. Since 1991, the Reach Out and Read model has been studied by academic investigators in a variety of settings, providing an extensive body of peer-reviewed research on the effects of the program. The body of published research supporting the efficacy of the Reach Out and Read model is more extensive than for any other psychosocial intervention in general pediatrics. Additional studies that address language outcomes in children are in progress.

Key Findings

Parents served by Reach Out and Read are up to four times more likely to read aloud to their children.

Reach Out and Read reaches the child through effectively teaching the parent to start lifelong learning in the home.

During the preschool years, children served by Reach Out and Read score three to six months ahead of their non-Reach Out and Read peers on vocabulary tests. These early foundational language skills help start children on a path of success when they enter school.

Studies

Reach Out and Read: Changing Child Outcomes

Reach Out and Read: Changing Child Outcomes

Mendelsohn et al., Pediatrics High-risk urban families participating in Reach Out and Read read more frequently to their children. Children exposed to Reach Out and Read had higher receptive language scores (words the child understands) and expressive language scores (words the child says). Increased exposure to Reach Out and Read led to larger increases in both receptive and expressive language scores. Mendelsohn A.L., Mogilner L.N., Dreyer B.P., Forman J.A., Weinstein S.C., Broderick M., Cheng K.J., Magloire T., Moore T., Napier C. “The impact of a clinic-based literacy intervention on language development in inner-city preschool children.” Pediatrics 2001;107(1), p. 130–134.

High et al., Pediatrics Families participating in the Reach Out and Read model read to their children more often (4.3 vs. 3.8 days/week), and their toddlers’ receptive and expressive vocabulary scores were higher. This effect held in parents of different levels of education and English proficiency. High P.C., LaGasse L., Becker S., Ahlgren I., Gardner A. “Literacy promotion in primary care pediatrics: can we make a difference?” Pediatrics 2000; 104, p. 927–934.

Theriot et al., Clinical Pediatrics Among children ages 33 months to 39 months attending a well-child clinic in Louisville, KY, expressive and receptive language scores were significantly and positively associated with both the number of Reach Out and Read-enhanced well-child visits they had attended, and with the number of books purchased for them by their parents. This finding supports a “dose effect” for the Reach Out and Read intervention: the more visits, the higher the score. Theriot J.A., Franco S.M., Sisson B.A., Metcalf S.C., Kennedy M.A., Bada H.S. “The impact of early literacy guidance on language skills of 3-year-olds.” Clinical Pediatrics 2003; 42, p. 165–172.

Sharif et al., Journal of the National Medical Association Children participating in Reach Out and Read had higher receptive vocabulary scores. They also had higher scores on the Home Literacy Orientation (measured by how much the child was read to and how many books were in the home) than children not participating in Reach Out and Read. Sharif I., Rieber S., Ozuah P.O. “Exposure to Reach Out and Read and vocabulary outcomes in inner city preschoolers.” Journal of the National Medical Association 2002; 94, p. 171–177.
Diener et al., Journal of Community Medicine and Health Education This study showed that a small sample of Latino children who participated in Reach Out and Read from six months of age had average or above average literacy skills by the end of kindergarten, as well as high-quality home literacy environments with frequent book sharing and high book ownership. Diener M.L., Hobson-Rohrer W., Byington, C.L. “Kindergarten readiness and performance of Latino children participating in Reach Out and Read.” Journal of Community Medicine and Health Education 2012; 2:133.  
Reach Out and Read: Changing Parental Attitudes and Practices

Reach Out and Read: Changing Parental Attitudes and Practices

High et al., Archives of Pediatrics and Adolescent Medicine Parents whose children (< 3 years) had received books and educational materials during well-child visits were more likely than parents in a control group to report that they shared books with their children, and to cite sharing books as a favorite activity or a child’s favorite activity. High P., Hopmann M., LaGasse L., Linn H. “Evaluation of a clinic-based program to promote book sharing and bedtime routines among low-income urban families with young children.” Archives of Pediatrics and Adolescent Medicine 1998; 15, p. 459–465.

Needlman, et al., American Journal of Diseases of Children Parents who had received a book as part of Reach Out and Read were more likely to report reading books with their children, or to say that reading was a favorite activity. The benefits of Reach Out and Read were larger for families receiving Aid to Families with Dependent Children. Needlman R., Fried L.E., Morley D.S., Taylor S., Zuckerman B. “Clinic-based intervention to promote literacy. A pilot study. ”American Journal of Diseases of Children 1991; 145,p. 881–884.

Weitzman et al., Pediatrics In a study using direct observation of children’s homes, parents were more likely to read aloud to their children and enjoy reading together when their families had more encounters with the Reach Out and Read program. Weitzman C.C., Roy L., Walls T., Tomlin R. “More evidence for Reach Out and Read: A home-based study.” Pediatrics 2004; 113, p. 1248–1253.

Needlman et al., Ambulatory Pediatrics In a multicenter study, families exposed to Reach Out and Read were more likely to report reading aloud at bedtime, read aloud 3 or more days per week, mention reading aloud as a favorite activity, and own 10 or more children’s books. Needlman R., Toker K.H., Dreyer B.P., Klass P., Mendelsohn A.L. “Effectiveness of a primary care intervention to support reading aloud: a multicenter evaluation.” Ambulatory Pediatrics 2005; 5, p. 209–215.

Silverstein et al., Pediatrics English and non-English speaking families who participated in the Reach Out and Read model increased their weekly bedtime reading, and more parents reported reading as their own or their child’s favorite activity. For non-English speaking families the number of children’s books in the home also increased as a result of the Reach Out and Read model. Silverstein M., Iverson L., Lozano P. “An English-language clinic-based literacy program is effective for a multilingual population.” Pediatrics 2002; 109, p. e76.

Sanders et al., Archives of Pediatrics and Adolescent Medicine Hispanic parents participating in Reach Out and Read were more likely to report reading to their children compared to Hispanic parents not participating in Reach Out and Read. When parents read more frequently to their children, they were also more likely to read frequently themselves. Sanders L., Gershon T.D., Huffman L.C., Mendoza F.S. “Prescribing books for immigrant children.” Archives of Pediatrics and Adolescent Medicine 2000; 154, p. 771–777.

Golova et al., Pediatrics Hispanic parents whose children had received bilingual books, educational materials, and anticipatory guidance about literacy were more likely to report reading books with their child at least 3 days/week (66% vs. 24%) and report that reading books was one of their three favorite things to do with their child (43% vs. 13%) than parents in a control group. Parents participating in the Reach Out and Read intervention also tended to have more books in the home (for children and adults). Golova N., Alario A.J., Vivier P.M., Rodriguez M., High P.C. “Literacy promotion for Hispanic families in a primary care setting: A randomized controlled trial.” Pediatrics 1998; 103, p. 993–997.

Reach Out and Read: Toward Better Primary Care

Reach Out and Read: Toward Better Primary Care

Jones et al., Clinical Pediatrics Parents participating in Reach Out and Read were more likely to rate their child’s pediatrician as helpful than those not participating. Pediatricians in the Reach Out and Read group were more likely to rate parents as receptive than those in the non-Reach Out and Read group. Mothers in the Reach Out and Read group were two times more likely to report enjoyment in reading together with their child than those in the non-Reach Out and Read group. Jones V.F., Franco S.M., Metcalf S.C., Popp R., Staggs S., Thomas A.E. “The value of book distribution in a clinic-based literacy intervention program.” Clinical Pediatrics 2000; 39, p. 535–541.

King et al., Academic Pediatrics Successful implementation of the Reach Out and Read program was related to the culture of the clinic. Staff at clinics that struggled to implement Reach Out and Read found their jobs burdensome and reported lacks in communication. Staff at successful Reach Out and Read program sites worked as a team and expressed strong commitments to their communities. King T.M., Muzaffar S., George M. “The role of clinic culture in implementation of primary care interventions: The case of Reach Out and Read.” Academic Pediatrics 2009; 9 (1), p. 40–46.

Byington et al., Journal of Health Care for the Poor and Underserved This qualitative study examined the thank-you notes sent to staff at a Reach Out and Read clinic by Hispanic families. Families expressed thanks for the books received, as well as the literacy advice given by doctors and nurses. Many families believed that the books and advice promoted the habit of reading and demonstrated respect the staff felt for the families and their children. Ortiz K.A., Buchi K.F. “The good habit of reading (el buen habito de la lectura): Parental reactions to an enhanced Reach Out and Read program in a clinic for the underserved.” Journal of Health Care for the Poor and Underserved 2008; 19, p. 363–368.

The learning gap: background

The learning or ‘achievement’ gap refers to the growing disparity in academic achievement between children from lower income homes and children from middle- and upper-income homes. Statistics show that children from lower-income homes are more likely to fall behind in school than their more affluent peers. And when they fall behind, they stay behind. Families can prepare children for school by reading aloud to children early and often, and, once children start school, by continuing to create a culture of reading at home.

  • “Research by Stanford psychologists reveals that 2-year-old children of lower-income families may already be six months behind in language development.” (Stanford News, Sept. 25, 2013)
  • “The National Household and Education Survey (NHES)—a nationally representative survey of households—asks parents of children ages 3–6 whether their child is able to do certain school readiness-related activities. Data from these surveys in 1990, 1993, and 2007 (years in which the questions were included) indicate that children from poorer families are less able to recognize their letters, count to 20, write their name, or read or pretend to read a book” (Lindsay, August 2010, Children’s Access to Print Material and Education-Related Outcomes).

Vocabulary Accumulation by Age 4
An average child in a professional family accumulates 45 million words
An average child in a working-class family accumulates 26 million words
An average child in a welfare family accumulates 13 million words
(Hart & Risley, 1995, The Early Catastrophe: The 30 Million Words Gap by Age 3).

Listening vocabulary at the start of Kindergarten
Child from low-income family have a listening vocabulary of 3,000 words
Child from middle-income family have a listening vocabulary of 20,000 words
(Hart & Risley, 1995, The Early Catastrophe: The 30 Million Words Gap by Age 3)

Children ready for school by age 5
Percentage of school-ready children from low-income families – less than 48%
Percentage of school-ready children from families with moderate and high income – 75% )
(Isaacs, March 2012, Brookings Institute)

New York State public school 4th graders who are NOT proficient readers:
Child from low-income* families – 77%
Other children – 47%
*based on eligibility for free/reduced school lunch
(KIDS COUNT Data Center)

26% of NYC students from low-income families not reading proficiently by the 3rd grade will NOT graduate.
(Citizens’ Committee for Children of New York (CCCNY))

Access to books & its impact on learning

Studies show that children who grow up in households with books have higher levels of school achievement – regardless of their parents’ education level. There is even evidence that the number of books at home has a greater impact on child literacy than a parents’ educational level.  Still, children from poorer communities tend to have less access to books in their neighborhoods, schools, libraries, and at home.  Ensuring that children have access to books is the first step in creating a foundation for academic success.

  •  “Not only do NAEP and NHES data suggest that less affluent children are less likely to demonstrate academic performance at the level of their more affluent peers, but several studies suggest that less affluent children have access to fewer books and other reading materials. Studies by Allington, Guice, Baker, Michaelson, and Li (1995); Neuman and Celano (2001); Di Loreto and Tse (1999); and Smith, Constantino, and Krashen (1996) all have demonstrated that children from poorer families have fewer books in their homes, have fewer books available in the school and classroom library, and live farther from public libraries than do children raised by middle- and upper-income families.“ (Lindsay, August 2010, Children’s Access to Print Material and Education-Related Outcomes).
Reading aloud for school readiness

Experts agree: reading aloud to children during the most critical years of brain development – 0-5 years of age – is one of the best ways to prepare children for school and for later school success. One of the advantages of reading aloud is that it creates a bond a parents and their children. Another benefit associated with reading aloud to children is the fact that it helps build the child vocabulary, which is proven to be the key for school readiness. It also fosters language development.                                                                              

  •  “Young children who are read to regularly by family members experience multiple benefits.  These include boosts in literacy development, as well as social-emotional gains, and increased likelihood of later overall school success.” (ChildTrends)

NEW RESEARCH!

A recent New York Times article, Language-Gap Study Bolsters a Push for Pre-K, reported new research affirming the need for increased investment in early childhood education and development programs like Reach Out and Read:

The new research by Anne Fernald, a psychologist at Stanford University, which was published in Developmental Science this year, showed that at 18 months children from wealthier homes could identify pictures of simple words they knew — “dog” or “ball” — much faster than children from low-income families. By age 2, the study found, affluent children had learned 30 percent more words in the intervening months than the children from low-income homes.

The new findings, although based on a small sample, reinforced the earlier research showing that because professional parents speak so much more to their children, the children hear 30 million more words by age 3 than children from low-income households, early literacy experts, preschool directors and pediatricians said.

But even in low-income families, parents who speak to their children more frequently can enhance vocabulary. In separate research, Ms. Fernald, working with Adriana Weisleder, a graduate student in psychology, recorded all the words that 29 children from low-income households heard over a day.

The researchers differentiated between words overheard from television and adult conversations and those directed at the children. They found that some of the children, who were 19 months at the time, heard as few as 670 “child-directed” words in one day, compared with others in the group who heard as many as 12,000.

Those who had heard more words were able to understand words more quickly and had larger vocabularies by age 2.

“Even in families that are low income and perhaps don’t have a lot of education, there are some parents that are very engaged verbally with their kids,” said Ms. Weisleder. “And those kids are doing better in language development.”

Read the full story…

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