Why Pediatricians Are Prescribing Books

Earlier this week, the American Academy of Pediatrics issued a policy statement recommending story time with mom and dad start in infancy: parents should be reading to their children, the group says, from the first days of their lives.

Research shows that one-third of American children start kindergarten lacking the basic language skills they will need in order to learn to read, a deficit that can ripple through all the years of schooling to follow. Reading aloud is one of the best ways to build such skills, but surveys find that only about half of low-income parents in the U.S. are reading to their children every day. Scientists have repeatedly demonstrated that better-educated people live longer and have a lower risk of disease than their less-educated counterparts. It makes perfect sense, then, that many pediatricians are adding a new tool to their doctors’ kits: books.

There are hurdles, however, in the way of many parents taking this advice: they may not themselves be literate, for example. A study released earlier this month by the Stanford University School of Medicine reported that immigrant parents and parents with low education levels or low household incomes were less likely to read to their children. In addition, poor families may not have access to books. One study found that in low-income neighborhoods, only one book was available for every 300 children, while in middle-income neighborhoods the ratio was 13 books for each individual child. And many parents may know that they should be reading to their children each day, but find that work schedules and other household activities get in the way.

Pediatricians make ideal conduits for the message that reading is important. Ninety-six percent of children under five years old see their doctor at least once a year, and the opinion of a physician often carries more weight with parents than that of a teacher or counselor. Taking advantage of this privileged position, a growing number of pediatricians are “prescribing” books to their young patients at each visit (some of them even write out the directive to read on a prescribing pad).

Many are doing so under the auspices of an organization called Reach Out and Read, which was founded in 1989 by a group of doctors at Boston City Hospital (now called Boston Medical Center). Over the past 25 years, Reach Out and Read has trained thousands of primary care providers to speak with patients about the benefits of reading. They have distributed millions of books through these medical partners. Each enrolled child gets a new, age-appropriate book at every well-child visit, from six months to five years of age. That means they’ll start kindergarten with a home library of as many as 10 books—and these are often the only children’s books they own.

When working with parents who are unable to read themselves, doctors in the Reach Out and Read program demonstrate how they can page through a picture book with their children, making up their own stories as they go. And when counseling parents who say they’re too busy or too tired to engage in story time at the end of the day, some physicians read aloud a book to their young patients right in the consulting room, to demonstrate to parents how quickly book reading can be accomplished and how much their children enjoy it. In another literacy-promoting program, developmental specialists at the Langone Medical Center at New York University actually videotape parents reading to and playing with their children; then the parents and the specialist watch the video together, a practice that encourages parental self-reflection and self-improvement.

Researchers who have evaluated the effects of Reach Out and Read report that participating parents are up to four times more likely to read to their young children, and that their children enter kindergarten with larger vocabularies and stronger language skills. Interestingly, families who participate in Reach Out and Read are also more likely to show up for their doctors’ appointments: yet another way that health and learning can work together.

Annie Murphy Paul writes The Brilliant Blog and is the author of the forthcoming book Brilliant: The Science of How We Get Smarter.