Far too many indigent children are failing to become successful students. Most of these children are born into poverty and do not have age-appropriate language skills by the age of 2.
Children who are not talking normally at age 2 are most likely to do poorly in first grade, and many of these children never participate meaningfully in the education process. It is important that the state develop an approach to learning that starts at birth and involves teaching parents how to assure the optimal early brain and language development of their children.
Reach Out and Read is an evidence-based program that primary care physicians use to encourage families to read to their young children. Through Reach Out and Read, primary-care health professionals give age- and culturally appropriate books to children, starting at 6 months of age and continuing through 5 years.
That means that during the preschool time frame, health care providers have at least 10 conversations with parents about the importance of reading and language development, and children go to kindergarten with a library of at least 10 books.
In addition, Reach Out and Read has a direct effect on the time parents spend reading with their children each day. The program trains and empowers parents, the first and most important teachers of our children.
There are 15 evidence-based and peer-reviewed studies that document the effectiveness of Reach Out and Read. The most recent evaluation of the program was published in the Journal of Community Medicine and Health Education in March.
In this longitudinal study, researchers examined the home literacy environments, teacher evaluations and reading readiness of low-income Latino kindergartners who had participated in Reach Out and Read from age 6 months. By the end of kindergarten, 77 percent of these children had average, above average or far above average literacy skills when compared with all students in the same grade.
In our community, we have been involved in the program for about 12 years. When I enter the exam room and give that shiny new colorful book to a child, the tenor of the office visit changes. I spend time, at each of these visits, talking with the parent about the importance of early reading to early brain and language development and to future school performance.
Not all primary care practices participate in Reach Out and Read. Our practice struggles to raise about $45,000 each year to fund the program. This cost is mainly for the books that we provide to children at each well-visit.
At least one-half of our preschool patients are on Medicaid. If Medicaid paid for the books for the eligible children, more practices like ours would be able to participate in Reach Out and Read.
There are thousands of children on the Reach Out and Read program waiting list. We can buy books for about $2.25 apiece if we are buying them for a large number of children. These are high-quality books vetted by a national committee of early-childhood and health experts.
Should North Carolina invest $22.50 per preschool child so that the parents of all our indigent young children have a better chance of entering kindergarten ready to read and ready to learn?
Primary-care health care providers have access to all the children and families in our state. It makes sense that the state would use this “captive audience” scenario to improve the likelihood that all our children will enter kindergarten ready to read and ready to learn.
Two-thirds of our at-risk children are not participating in preschool programs in spite of the strong efforts of Smart Start. More than 95 percent of children ages 6 months through 5 years visit their pediatric care provider regularly, but less than one-third of these children are enrolled in a child care setting.
We must find a better way to help the parents of our at-risk children assure that the children are prepared for the challenges of our public education system. Investing in Reach Out and Read through Medicaid would be a very logical, evidence-based and cost-effective first step.
David Tayloe of Goldsboro is a past president of the American Academy of Pediatrics and the N.C. Pediatric Society, a member of the Governor’s Early Childhood Advisory Council and a member of the Board of Directors of Action for Children NC.