Early Literacy Research Library (ELRL) - Article

A Pediatric Clinic-Based Approach to Early Literacy Promotion–Experience in a Well-Baby Clinic in Taiwan

Wu, S.C., Lue, H., Tseng, L. (2012) A Pediatric Clinic-Based Approach to Early Literacy Promotion - Experience in a Well-Baby Clinic in Taiwan. Journal of the Formosan Medical Association, 111(5), 258-264.,

Access: Institutional Access

Publication year


study description

Controlled intervention study.

Population Characteristics

International , Race, Ethnicity, and Culture

Exposures, Outcomes, Other

Implementation and Evaluation , Parent Knowledge, Attitudes, and Beliefs , Parent-Provider Relationships/Interactions , Reading Frequency


Reach Out and Read (ROR) is an evidence-based intervention situated in pediatric offices and can help pediatricians to promote parents' reading to their children. The objective of this study was to determine if the program could also achieve good results in different culture, such as in Taiwan.


Reach Out and Read (ROR).

outcomes evaluated

Parental attitudes towards reading with children.


Well-baby clinic at Lotung St Mary's Hospital in Taiwan.


The intervention group (n=205) was enrolled from a well-baby clinic participated in a program modified from ROR (receiving anticipatory guidance and an appropriate children's book at a well-baby clinic) at a mean age of 9 months. The control group (n=210) was recruited from a general pediatric outpatient service at the compatible age. Both groups were queried about the reading habits of primary caregivers and the frequency of book sharing with their child. When children were at aged 12 to 18 month, follow-up questionnaires were collected.

sample size

n=205 (intervention); n=210 (control); n=415 (total)


Measure of Child Centered Literacy Scores: questionnaire assessing frequency of shared reading, reading as one of their three favorite interaction activities and child interested in shared reading:

    1. demographic information
    2. literacy variables (caregiver’s reported reading habit and education level)
    3. home literacy (frequency of book sharing, reading as one of three favorite interaction activities)


At follow-up, ANCOVA analysis indicated that the intervention group exhibited significantly greater increase in child-centered literacy scores (frequency of shared reading, reading as one of their three favorite interaction activities and child interested in shared reading). Caregivers were willing to accept their pediatrician's advice to read to their infants.


In this study, the simple intervention, implemented at a well-baby clinic in Taiwan, changed Taiwanese parents' attitudes toward the importance of reading with their infants and toddlers. As primary health care providers, pediatricians are in a unique position to affect and encourage parental behaviors that foster early literacy development in children.


First, family income is an important factor influencing parent child reading together; however, many adult participants refused to answer this item in the questionnaire; thus the influence could not be examined in this study. Second, although the best measure of a book-sharing environment and interaction is through direct observation in the subject’s home, we used parental report as a more convenient and less costly means of measurement. Social desirability might induce parents to over report their reading attitudes and behaviors, but researches showed that outcome of children based on direct-blinded measurement was similar to parent-report studies.