Effects of Early Literacy Promotion on Child Language Development and Home Reading Environment: A Randomized Controlled Trial

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Download the full text: Guevara_2020_Effects of early literacy promotion on child language development and home reading environment – a randomized controlled trial

Publication year

2019

study description

Hybrid type 1 randomized controlled implementation trial.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

Infant/Newborn , Medicaid , Urban

Exposures, Outcomes, Other

Home Language/Literacy/Learning Environment , Language and Literacy Development , Technology and Digital/Screen-Based Media

metric(s)

StimQ Cognitive Home Environment Questionnaire (StimQ)
Preschool Language Scale (PLS)

objectives

To determine if early literacy promotion, which consisted of board books and reading promotion beginning with newborns, is more effective than standard literacy promotion beginning at 6 months.

exposure

Reach Out and Read (ROR) from infancy.

outcomes evaluated

Home reading environment and language development.

setting

Medicaid-eligible newborns recruited from a single urban pediatric practice affiliated with the Children's Hospital of Philadelphia.

methods

Hybrid type 1 randomized controlled implementation trial of Medicaid-eligible newborns. Prior to 6 months of age, early literacy promotion participants received board books and reading promotion at well visits plus weekly text messages on reading, while standard literacy promotion participants only received weekly text messages on safety. Both groups received board books and reading promotion at well visits after 6 months as part of Reach Out and Read.

sample size

n=120 (newborns, mostly African American)

measures

Measure of Implementation: proportion of eligible participants who received board books

 

Measure of Language Outcomes: StimQ READ Subscale (SQRS) scores and Preschool Language Scale-Fifth Edition (PLS-5) scores at 6 and 24 months.

results

Of 120 newborns enrolled, most were African American, resided with a single parent, or had a parent with ≤high school education. Overall, 82% of early literacy promotion participants received books/counseling at well visits <6 months old. Children in the early literacy promotion arm had greater SQRS scores (11.0 vs 9.4, P = .006) but similar PLS-5 scores at 6 months, but there were no differences in SQRS or PLS-5 scores between groups at 24 months.

conclusions

Implementation of a literacy promotion program early in infancy was associated with richer home reading environments at 6 months but did not improve language development. Although an early literacy program was feasible, additional study may be needed to assess other potential benefits.

limitations

First, the study was conducted at a single large urban pediatric practice affiliated with a children’s hospital and provided care to a predominantly poor African American population. The results may not be generalizable to patients attending pediatric practices in other geographic areas or to children of other race/ethnicity groups. Second, families in the early literacy promotion group reported only modest increases in reading frequency and board books at home in the first six months compared with the standard literacy promotion group. Many of the participating families had older children and were likely exposed to the ROR Program at the practice, which may have diluted the effects of early literacy promotion. For example, families in the standard literacy promotion group reported shared reading on average 3.1 days per week prior to the 6-month visit. Third, the comparator for early literacy promotion was standard literacy promotion using an established ROR program and not a no intervention control group. Readers should not interpret results to suggest that literacy promotion among infants is ineffective. Fourth, we did not exclude children with chronic health conditions like recurrent otitis media. Finally, we assessed the effects of early literacy promotion on the home reading environment and language development. Other potential benefits such as improved socioemotional development, parenting, and attachment were not measured.