By Dr. Nikki Gambhir
Developmental-Behavioral Pediatrician
Assistant Professor of Pediatrics
Baylor College of Medicine | Texas Children’s Hospital
One of my favorite parts of my office is the bookshelf filled with well-loved copies of “Chicka Chicka Boom Boom,” “Brown Bear, Brown Bear, What Do You See?,” Raffi sing-along board books, a selection from the “That’s Not My…” series, “Dog Man,” Sandra Boynton’s greatest, and many others. Over the years, that bookshelf has become just as valuable to me as more formal assessment tools in my office.
I was reminded of that recently while evaluating a young child who was having difficulty engaging in the social demands of the visit. The blocks, puzzles, and testing materials I presented were met with little interest. As I spoke with his parents, they mentioned his fascination with fish. Ah-ha! I stepped out briefly, scurried to my office “library,” and returned with a pop-up book about ocean life. Almost immediately, the visit shifted. He moved closer, pointed to pictures, labeled fish, turned pages, and shifted his gaze towards me. A challenging evaluation suddenly became an opportunity to observe communication, attention, learning, and social engagement in a way that felt natural for him.
My exposure to Reach Out and Read during pediatric residency sparked an interest that continued to grow throughout my DBP fellowship. DBP specialists evaluate and care for children with developmental, learning, behavioral, and neurodevelopmental differences — including conditions such as autism, ADHD, intellectual disability, developmental delays, and learning disorders. DBP can sometimes feel like a field centered on identifying challenges, delays, diagnoses, and areas of need, but we also have the privilege of promoting development, fostering school readiness, supporting Early Relational Health, strengthening parent-child relationships, and helping families recognize and build upon their child’s strengths. Reach Out and Read aligns naturally with those goals by giving clinicians a practical, relationship-centered tool that can be used across settings and developmental stages.
During my fellowship, I became increasingly interested not only in how we train pediatric residents to implement the Reach Out and Read model with fidelity, but also in the many ways books can be used in clinical practice for developmental assessment and relationship building. In DBP, we often meet children whose strengths may not be fully captured through traditional testing activities. We also meet caregivers and trainees who want to connect with and support a child but are unsure how to navigate communicative, social, behavioral, or sensory differences.
Now, as an early-career DBP physician, I can demonstrate how following a child’s interests — sharing enjoyment around an image, sensory feature, or story — and engaging in responsive, back-and-forth interactions can inform my evaluation, support language, cognitive, and fine motor development, and promote interactions with children. Parents leave with practical, evidence-informed strategies they can use at home, while residents witness how developmental surveillance and assessment can occur through connection rather than compliance.
Although only a small number of pediatric residents will pursue careers in DBP, nearly all will enter primary care or pediatric subspecialties. In many ways, they will have more opportunities than I do to monitor and optimize children’s developmental trajectories and support families as concerns arise. I try to impress upon residents that the skills fostered through Reach Out and ead — observing, connecting, coaching, and promoting shared reading — are relevant across every pediatric setting, regardless of specialty.
Looking back, one of the unexpected gifts of my fellowship training was realizing that a book can be much more than a primary care literacy intervention. Whether it is a copy of “Pete the Cat” or a pop-up book about fish pulled from a shelf at just the right moment, books are clinical and teaching tools — and, perhaps most importantly, bridges to connection. In DBP, connection is often where the most meaningful work begins.