Saturday, November 8, 2014

Public Health Issue: Literacy Promotion

The American Academy of Pediatrics (AAP) is currently engaged in literacy promotion as an essential part of pediatric well-child visits.  AAP has engaged in a number of researches that shows that literacy is an important public health issue that involves literacy skills, brain development, and parent-child relationships. (American Academy of Pediatrics, 2014)  Reading statistics in the United States are not the best they can be when comparing with reading scores of other countries.  The Academy is also fully aware of the competing interests such as electronic media and limits such as parental awareness.

Although AAP is focused on literacy promotion, American Academy of Pediatrics (2014) also states:

 Promoting literacy with parents of children beginning in infancy supports the recommendations of the AAP that children younger than 2 years not view electronic media and that older children and youth have no more than 2 hours daily of media exposure by offering parents a positive alternative for entertaining young children, for nurturing early relationships, and for developing healthy bedtime routines. (p. 5)

When families with infants and young children visit the participating pediatricians, they will hear a discussion and encouragement that they read to their infants.  They also have partnered with a non-profit organization, Reach Out and Read (ROR) who is presently actively promoting literacy among underrepresented minorities such as American Indian, native Hawaiian, and Alaska native populations. They are also working with military families, libraries, and schools.

One in three American children start Kindergarten without language skills needed to learn how to read. (AAP, 2014)  Reading with infants and younger children are associated with improved preschool language and literacy skills.  Children at 3 years old are more talkative than those that were not read to.

We have seen statistics often.  Children from families of poverty know and speak fewer words than those children from well-off families.  Sometimes, even well-off families have plenty of books at home but do not read directly with their children.  AAP wants to encourage all families to sit down, read, and engage in one-to-one conversations.  It has been suggested that a students’ reading skills at third grade is an indicator of their future academic success.

We studied in this class how this type of conversation with an adult stimulates brain development.  The more fully developed a brain is, the better the adult can function in the world. Another reason why literacy is important for adults is when they can read about their own health issues. If they are not literate, they are unable to read medical information that can save their lives.

Ultimately, every person wants a healthy relationship with one’s parent. When parents and children are engaged in book reading, it promotes a healthy relationship where they can both communicate their emotions, dreams, and expectations.  This communication between parent and child can be extended to family members and into the community when children become adults and participating as full members of the American society.

5,000 pediatricians have voluntarily participated in field-testing and created a set of recommendations for the literacy promotion. They came up with the following 5 recommendations:
1.     Advising all parents that reading is healthy;
2.     Counseling parents about developmentally appropriate reading activities;
3.     Providing developmentally and culturally appropriate books
4.     Providing additional information about libraries, materials and tookits that could help parents without resources.
5.     Partnering with other child advocacy organizations to promote literacy.

In support of school readiness, they also promoted with their patients the following 5Rs:
1.     Reading together as a family
2.     Rhyming, playing, talking, singing, and cuddling together
3.     Routines and regular times for meals, play, and sleeping which help children to know what to expect and what is expected from them.
4.     Rewards for everyday successes;
5.     Relationships that are reciprocal, nurturing, purposeful, and enduring.

Those are the foundation of a healthy early brain and child development. (AAP, 2014)

When the reading scores of the United States compare with the rest of the world, we are not performing up to par. The top seven countries are in Asia.  The top is technically not a country but a city in China.  Shanghai has a mean reading score of 570.  The United States ranked 36th with a mean reading score of 498. (Sedghi et al, 2014)

I had always believed that language and literacy are two of the important springboards to personal and life accomplishments.  In 1997, I was one of the four founders of an organization that promoted language and literacy.  We called it Alliance for Language and Literacy for Deaf Children (ALL for Deaf Children).  We sponsored a monthly book reading at libraries and bookstores, a quarterly lecture series with professionals, and holiday parties for all families with Deaf children and with Deaf parents with hearing children.

Language acquisition, language development, and literacy of Deaf children are critically important, and yet, those are polarizing issues between the proponents of spoken English and supporters of American Sign Language (ASL).  I would love to find ways to make both groups of supporters to collaborate more to benefit the Deaf and hard of hearing children who deserve to be in the center of the debate.


American Academy of Pediatrics. (2014) Literacy promotion: An essential component of primary care pediatric practice. PEDIATRICS. 134(2), 1-.6 doi: 10.1542/peds.2014-1384

O’Keefe, L. (2014) Parents who read to their children nurture more than literary skills. AAP News. doi: 10.1542/aapnews.20140624-2)

Sedghi, A., Arnett, G., and Chalabi, M. (November 2014) Pisa 2012 results: which country does best at reading, maths, and science? The Guardian. Retrieved from:


  1. Good information, I often encourage my families to read daily with their children to increase vocabulary. I work in low- income neighborhoods and when I enter the home the parent is watching the television. It is sometimes hard to encourage a parent to spend time interacting and reading to their child. I try to demonstrate those skills when I am at the home.

  2. Thank you for sharing this! It is very interesting to know that pediatricians have begun to share the importance of reading with their patients families. I am very interested in ready the study to learn more about it and how it can be incorporated into other pediatricians offices.

  3. Fabulous post! You shared very valuable information with us!
    I can attest to the fact that reading to our children is extremely important when it comes to literacy, and that it encourages healthy relationships. I was not always very good about reading to my children each night. Once my oldest daughter entered first grade and was having trouble learning to read, it was kind of a wake up call that I needed to do something different.
    Since I started reading to her and having her read to me or her younger siblings each night, her reading level and comfort with reading have increased dramatically and her sister that is one year younger than her is doing great with reading as well! Coincidentally my 2 year old son's favorite thing to do is look at books (well second to jumping off of things:)

  4. Thank you for these great facts about literacy and the importance of books and reading for a child's healthy brain development. I had never heard of the 5 R's! What a great idea. Thank you for your work with the deaf population and reading. I never thought about how a deaf parent would read to their child.