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Aligning Reach Out and Read with Research

Extending our program to the first few months in accordance with research demonstrating the importance of the first few months to a child's foundation for success.

A guest blog from Teandra Ramos-Hardy, MSW, Director of Medical Engagement for Reach Out and Read Carolinas

Reach Out and Read in InfancyWe know from research that brains are built over time through a process that begins prenatally. The Center on the Developing Child at Harvard University has an abundance of research confirming that the foundation for all future learning is shaped by early experiences, beginning at birth.  A brain's architecture does not grow in isolation; it is developed by interactions with both genes and experiences.  The early years are the most active period for establishing neural connections in the brain.  The environment where one lives and grows, and the exchanges that take place with people in the environment shape the capacities that emerge in the early years.    

In the very first few weeks and months of life, milestones can be seen that reinforce the construct of brain architecture.  A newborn does not immediately have neck control, but a newborn's head gradually wobbles less in the weeks after birth.  One of the best times to observe this is during tummy time.  A newborn will also become responsive to sounds, especially their mother's or caregiver's voice.  They will become drawn to the voice and respond by focusing in the direction of the sound.  A newborn can also communicate by being quiet, cooing or babbling, and reaching.

The postnatal period is a critical time for newborn babies and mothers and many changes occur during this period. Although manuals are helpful, they are not provided at discharge from the hospital, and the web is overloaded with information that can easily overwhelm new parents.  The pediatric provider is the filter and support system a family needs to navigate through information they'll receive to care for their newborn.  Lack of appropriate care during this time can result in significant issues lasting into adulthood.  Newborns and mothers should be assessed at regular intervals following delivery. Further evaluation can be achieved through referrals from the healthcare provider as needed.  The American Academy of Pediatrics has developed a periodicity schedule that providers can follow to assess the health of the newborn, and the health and emotional well-being of the mother. 

The newborn checkup is an important medical visit for the provider to assess the health and development of the newborn following discharge from the hospital.  This initial visit with the healthcare provider allows the family to begin building a relationship with the provider and the medical home as important resources for them and their child - a partnership that lasts throughout the life of the child.  Although the newborn checkup is for the new patient, it is equally important to focus on how the entire family is adjusting to the new addition to the family.  This visit sets the expectation for the two-generational relationship that is created, and includes asking questions, addressing concerns, and providing parent education and anticipatory guidance.

Reach Out and Read Early YearsProviders spend time educating and giving anticipatory guidance to parents.  It has been found that books effectively increase maternal knowledge of anticipatory guidance material and encourage social and emotional bonding between parents and babies.  During well-child visits, parents are educated on many topics, and are likely to recall less of the information as more topics are covered.  Given the brevity of pediatric visits, providers can target behaviors like reading, talking, singing, cuddling, and bonding that are important. Embedding Reach Out and Read in the standard of medical care offers additional opportunities to encourage parent-infant reading, which influences parent-child interactions, children's language development, and future reading ability. The value of the intervention has been shown in lower maternal depression scores, and reports of maternal enjoyment of reading, and time spent reading with their children.  This is significant because the AAP supports maternal depression screenings per "Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice," beginning at the one-month well-child visit.

The research supports the value of starting Reach Out and Read in infancy.  Through this early literacy intervention, providers can support parents and impact children's lives from the beginning.  Here in Reach Out and Read Carolinas, we are joining with a National Reach Out and Read initiative to align with science and incorporate a zero to 6-month component of the Reach Out and Read program, encouraging our providers to talk with the pediatric patient and family about the importance of engaging with infants and sharing books in the first few months.  Research on the impact of this early intervention will continue to inform and guide our rollout across the country.

Written by Teandra Ramos-Hardy at 17:07

Positive Parenting Overcomes the Effects of Poverty on Brain Development

New research shows that positive parenting can overcome the effects of poverty on healthy brain development in adolescents.  In a report published in the Journal of the American Medical Association, Brody and colleagues described a neuroimaging study demonstrating that supportive parenting prevented the reduced growth of certain areas of the brain that occurred as a response to living in poverty.

Positive parenting and brain development

Numerous studies on the association of poverty with poor academic and psychosocial outcomes in childhood have pointed to the critical role of stress on brain development. Physical and social stress that often occurs during childhood in lower socioeconomic environments can influence the growth of the brain. In particular, there is evidence that development of the amygdala and hippocampus, brain regions that support learning, memory, mood and stress reactivity, is suppressed in disadvantaged children.

Brody et al conducted a neuroimaging study on 119 25-year-olds who had participated as adolescents in the Strong African American Families randomized trial (SAAF), a program designed to mitigate the negative effect of life stress on rural African American youths by encouraging positive parenting.  The intention of the study was to correlate the size of specific areas of the hippocampus and amygdala in these individuals, as determined by magnetic resonance imaging, with the number of years between the ages of 11 and 18 that they had lived under the federal poverty line. 

The results showed that, in the control population that had not been enrolled into the SAAF program, more time spent living in poverty was associated with smaller than average volume in areas of the amygdala and hippocampus. The good news was that this suppressive effect of poverty on brain maturation was prevented in those youths whose families had the benefit of the SAAF intervention. The promotion of positive parenting had conferred resilience to the stress of poverty. Importantly, this protective effect was detected at age 25 - it had lasted into adulthood. 

Interestingly, these positive results were achieved in a program serving the families of adolescent children. More than 95% of brain development occurs during the first six years of life, and the brain is particularly susceptible to the stress associated with poverty during this timeframe

Through the Reach Out and Read program, pediatric care providers are able to take advantage of their access to children during these early years. They encourage parents to spend time engaging with their young children through looking at books together starting in infancy,building the parent-child bonds that will alleviate the effects of adverse circumstances in the early years. 

This study encourages us that, through interventions that help parents to bring up their children in a positive, responsive way, it is possible to buffer against the consequences of poverty and low socioeconomic environments.  Leveling the playing field for disadvantaged children in this way can contribute to closing the achievement gap.

Written by Nikki Shearman at 08:32

How to Be Your Baby's First Teacher

Talk, Read and Sing to Your Baby from the Very First Day
Written by Dr. Amy Emerson, Pediatrician, Tulsa, Oklahoma at 15:05

The Importance of Encouraging Parents to Read Aloud to Their Young Children

There is a well documented and growing achievement gap between children growing up in the United States that starts in early childhood and persists through school and college into adulthood. It has become increasingly important to determine the factors that affect child development, both positively and negatively, so as to identify how we can give every child the opportunity to grow up into well-rounded adults. This is important for the future of our families, our communities and our nation.

Encouraging Parents to Read Aloud to Their Young Children

Advances in neuroscience technology over the last two decades have allowed us to chart human brain development. The evidence is still accumulating, but it is now well established that our brains develop most rapidly during the first few years of life. The brain has reached 95% of its full size by the age of six.1

Areas of the brain associated with specific skills develop sequentially - the sensory pathways develop first, followed by connections that result in language capability, followed by higher cognitive function. What is most significant is that maximal development for all functions occurs during the first five years of life.3

Child development studies have shown that the architecture of the early developing brain is influenced by a child's experience. Nurturing from a loving parent or caregiver stimulates the brain to develop the circuits that provide the foundation for emotional well-being, social competence and cognitive abilities. Conversely, adverse experiences prevent the brain from developing to its full capacity.

The best time to have an impact on children's achievement is during this critical window of early brain development, from birth through five years. And the best way of positively influencing early brain development is to strengthen the capacity of adults to nurture their children. Giving parents guidance about cuddling, talking to, and playing with their infants and toddlers will help them to support their child's development.

So, how do we reach parents of young children with this guidance?

This is where Reach Out and Read comes in! Our program is integrated into the pediatric healthcare system, so that we have repeated and unparalleled access to families with children from birth through five years at well-child checkups. Over 84% of children visit a pediatric healthcare provider during their first year.  By offering guidance about reading aloud to infants and toddlers, as a simple way of encouraging language-rich nurturing, our medical providers can help parents to give their children the best start in life.

1Lenroot, R.K. & Giedd, J.N Brain development in children and adolescents: Insights from anatomical magnetic resonance imaging. Neuroscience and Biobehavioral Reviews 30 (2006) 718-729 


 

Written by Nikki Shearman at 09:04

Creating Fond Memories of Reading Together With the People Who Love Us

When we look back on our childhood, many of us have fond memories of being read to, of snuggling up and enjoying a favorite story with the people who love us. And it's not so much the story that we remember, but the feeling of love and security that it gave us. My father sat and cuddled my brother, my sister and me every evening when he came home from work. We would sit all together on the bed in our PJs, and he would read us a story, or, if we were really lucky, make up one of his own. My favorite was about a cabbage that uprooted itself and went on a journey to become king of the vegetables!

Creating Fond Memories of Reading TogetherIt turns out that what has been a time-honored tradition in so many families is actually a wonderful way of helping children to reach their full potential. We now know that when parents spend time focusing on their young children, it stimulates their brains to create connections that last a lifetime. Reading aloud gives children important early literacy skills and a love of reading. More importantly, the act of enjoying time together as a family creates the bonds that will give children a foundation for future learning and for building loving relationships.

At Reach Out and Read, we believe that all families should have the tools and information needed to make reading aloud a daily routine. There are many parents who want to do the best for their children but don't know that the simple act of reading aloud to their infants and toddlers every day can make a world of difference.

Our Reach Out and Read doctors and nurses have unparalleled access to families with young children at a time when many are not given any other formal advice about parenting. They give a new book to each child at their pediatric check-ups, and guidance about the importance of reading together.

It is a privilege to be able to help families create their own memories of reading aloud together. A Reach Out and Read doctor in Saucier, MS, told us this story:

"I know that Reach Out and Read makes a difference to my patients. When I give my patients their first book at the 6 month old well-child visit, I am often told this is the only book in the home. The simple gift of one book opens a door of possibility in the minds of the child's parents. For the first time they consider the value of books in the home life of their child. They usually come back at the next well-child visit saying they have acquired a few other books for the child that he enjoys sharing with his parents."

Written by Nikki Shearman at 09:00

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Reach Out and Read National Center
89 South St, Suite 201
Boston, MA 02111