Photo: Kate Samp for Strategies for Children

In 1989, pediatricians at Boston City Hospital (now Boston Medical Center) launched Reach Out and Read. The idea was simple. Pediatricians would promote children’s reading readiness by dispensing books and advice to parents on reading aloud at the check-ups of children from 6 months to 5 years.  Today Reach Out and Read has more than 4,500 programs nationwide and distributes books to almost four million children. Recently, pediatric staff at Bellevue Hospital, a public hospital in New York City, studied the effect of building on the Reach Out and Read model by starting with newborns at two weeks and giving out toys as well as books. They found increased parent-child interactions.

Researchers studied two methods of intervention with low-income families. One group of mothers and their newborns were assigned to the Video Interaction Project (VIP). They participated in one-on-one sessions with a specialist, who discussed child development with the mother and gave her toys or other learning materials. The mother was then videotaped playing with her child, and the child development specialist reviewed the video with her. The second group, the Building Blocks (BB) group, was mailed parenting newsletters with age-specific suggestions for activities as well as questionnaires to complete. Families in both groups and the control group participated in Reach Out and Read.

Although both the VIP and BB interventions led to increased interactions between parent and child, the greatest impact came in the video group. Researchers also found a decrease in children’s exposure to television and other media in the VIP group. The results appear in two related studies in the January issue of Archives of Pediatrics and Adolescent Medicine.

Dr. Alan Mendelsohn, the studies’ lead researcher, recently brought some videos to the studios of National Public Radio. (Read the story l Listen to the story)

“On the screen, a mother and her 2-month-old were given a mirror to play with. The mother patiently held the mirror to the child, but didn’t say much,” NPR reports. “’The mother is holding the mirror up to the child, but is not really paying that much attention to the child,” Mendelsohn says. ‘She’s not talking to the child. She’s not looking to see when the child is interested.’ And so, after making a video like this, the child development specialist will show it to the mother herself and suggest ways that she might behave differently: Use the mirror to talk to the baby about reflections, or the color of eyes, use the mirror to engage the baby.

“It is these micro-behaviors that add up to macro-differences, Mendelsohn says. To all the millions of words Betty Hart’s children were missing, he points to the study’s results. ‘Mothers had roughly a doubling in the amount of certain kinds of labeling activities,’ Mendelsohn says. ‘And a 50 percent increase in the degree to which they reported that they talked about the events in the child’s life … and what was going on in the surroundings of the child.’”

As important as creating a language-rich environment is for infants and toddlers, families, early learning settings and schools must build on this foundation. “Russ Whitehurst, a researcher at the Brookings Institution who studies these issues, warns that, though laudable, teaching a low-income mother to talk to her baby as she walks through a grocery store will not by itself transform the educational achievement gap,” NPR reports. ‘If that’s not followed with good stimulation in school, with continued positive parent interactions, if that experience is not built on, it’s not likely to have an enduring effect,’ Whitehurst says.”

Mendelsohn discussed the role of pediatricians in school readiness with Education Week’s “Inside School Research“ blog. “Children have to come in for immunizations and screenings … and this provides an opportunity for working with families who may be at risk at relatively low-cost. We can build on the fact that families already have to be there, and that the infrastructure is already there,” Mendelsohn says.

“I think what we’re doing in health care is looking to reinforce what is happening in the early childhood education system,” Mendelsohn adds. “We don’t have the opportunity to work directly with children that the early childhood educators do. What we do have is the opportunity to work with virtually all students … at the earliest age possible.”